I have a case that is really troubling me and Im not sure what else to
do or what I should of done that I didn't do....
5 day old female infant, birth weight 6-6 born to a G 1 mom via c
section on the 18th for CPD. Infant to breast soon after delivery, did
not latch well. Mom with flat nipples and large breasts, denies any
breast injuries or surgeries and state they became larger during
pregnancy.
Infant continued poor latching, would latch for a few seconds take a
few sucks pull off and go off and on this way, sometimes fussy and
sometimes awake and alert, but would not stay attached. Mom the most
patient and gentle mom I have seen in ages, baby gets jaundiced and gets
phototherapy by bili blanket, mom keeps baby in room at all times, day
and night, another LC worked with her before I came on the scene on the
22, baby has now lost 11% weight, mildly dehydrated, started on SNS,
this helped slightly but baby still off an on and off and on, started
mom pumping and at day 4 breasts were very slightly firm and mom able to
pump only about 20cc total with hospital grade double pump. Mom REALLY
wants to nurse but is frustrated, at one point she tells me maybe its
hereditary as her mom told her that she wouldn't nurse as a baby either
(I educated her on this), I spent hours with this mom and baby, this
morning when I went baby to work, baby had gained an ounce from
expressed milk and lactofree formula that was mostly syringe or finger
fed as baby would not stay at breast long enough to get anything.
--
Today tried silicone nipple shield with SNS with only minimal
results.... baby would latch and suckle with a normal breast suck on a
finger on digital exam, oral and facial anatomy appear WNL, active alert
adorable happy baby....
What have I overlooked, what else could I of done and still do???
This baby d/c today, mom with good double pump and plans to try SNS
andshield at home with frequent follow ups.
Thanks for you input
Cindy
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Cindy Curtis , RN, IBCLC ~ Virginia , USA mailto:[log in to unmask]
Benefits of Breastfeeding Home Page http://www.erols.com/cindyrn
"Never doubt that a small group of thoughtful, committed people
can change the world. Indeed it is the only thing that ever has."
-Margaret Mead
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