I recently worked with a baby also finally diagnosed with Laryngomalacia and
latter reflux. At the breast the baby spent more time trying to breath and
maintain an airway than nurse. I really feel the priority when a baby cannot
breastfeed effectively is to find a way to FEED the baby so it can grow. In
two of the replies I hear "failure to thrive" and "small". I am concerned
that in some medical situations that we may do more harm then good when the
bottle is avoided and seen as the enemy. The baby I worked with did not even
to well with a bottle with a regular hold and mom was feeding it every hour.
When we were able to get a referral to an OT she was able to assess and
teach the mom to feed the baby turned on her right side with the baby's head
away from the moms body.  This position dramatically decreased the stridor
and the baby was able to breath and feed. The baby was then was able to take
enough by bottle in this position to feed every 2-3 hours. The baby has
never had an issue with poor growth and is meeting developmental milestones.
The mother and I also talked about creating some sort of wedge that they
could lean on to create a similar position for breastfeeding that she uses
to bottle feed as an option to try breastfeeding.
I also need to disagree that saying the PUMP N STYLE will not maintain milk
supply. The issue is frequency and how well the breast is  emptied.  Having
a busy mom lug around a heavy pump that will not be flexible to a busy
lifestyle will cause her not to pump frequently and then her supply will
definitely decrease.
The "enemy" in the situation of  laryngomalacia is the airway, and it is so
important to find a way to feed the baby efficiently in a reasonable amount
of time so it can grow. I am not sure that avoiding a bottle is the answer.
There is not alot out there about  laryngomalacia and successfull
breastfeeding. So I would love to hear about successes with good growth.
Thanks
Karen Querna, RN, BSN, IBCLC
Spokane WA

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