I need some help with this mom and baby.  The baby is now 9 weeks old
and since birth, after 5-10 minutes of nursing, comes off the breast and
cries until she is exhausted.  She then will continue nursing for 5 to
10 minutes, falls asleep for 1-2 hours. Baby then wakes up and goes
through the same routine.  This goes on during the day and evening,
middle of the night feedings when the breasts are firm and full there is
less problems getting the baby to stay on and nurse. Sidelying position
often used.
Maternal history is unremarkable. Mom is off dairy products for the last
3 weeks.  Mom nursed last child 26 months with no problems.

Infant has a high palate, nasal congestion noted at times.  Baby has
spit a lot since birth, and mom says milk often comes out the nose.
Sounds like the tongue is breaking suction during nursing. Frequent
clicking and flutter-sucking observed. Suck-swallow is 1:1 to 3:1 and
2-3oz feed in 5 to 7 minutes on one breast.  Digital exam; gags easily,
difficult to get baby to suck, abnormal rhythm, reverse tongue motion at
times and lack of proper suction.

Baby has gained weight adequately, mom has not had sore nipples,
frenulum is normal.  When baby is in cradle position and starts
screaming after 5 minute feed, putting baby on the shoulder baby stops
screaming.  Abdomen is not tight and no large amount of gas noted.
All nursing positions have been tried.
Mother is upset but wants to continue nursing.  Mom says it seems like
the milk comes too fast sometimes.  Would appreciate input on this one.
Thanks, Sara

Sara Macy, RN IBCLC


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