Colleagues: Suggestions sought for this difficult situation. I am seeing
a 11 week old baby who is an inefficient nurser. Birth history was
normal. but baby didn't latch well, mother had sore nipples early on.
Mother told baby's mouth too small for her nipples. Baby weighed 6#3,
6#9 @ two weeks. Mother told to begin supplements because he cried so
much. Weight gain continued to be okay, yet increasing supplements give
till baby was getting 20+ ounces. Mother continued to breastfeed, but
baby falls asleep at the breast. By 2 months, milk supply pretty low.
Mother sought help of hospital LC who recommended a good pump and SNS.
Mother didn't like the feeding device, but uses pump. I was called to
see baby at 9 weeks. Mother's nipples were raw, position very poor, so
we worked on that. Baby nurses a little better, but doesn't really drain
the breast well. Mother able to drop the amount of formula significantly
(12 oz), and can and collect 10oz/day in addition to breastfeeding. Her
goals are: total breastfeeding, or provide enough breastmilk to
eleiminate formula. Baby had severe diahhrea when she tried fenugreek to
increase milk volume. She pumps frequently, feeds. Her best feedings are
at night after she and baby have slept for 4-5 hours and there is a
bigger volume of milk. Husband starting to get tired of all this. Baby's
behavior is the key, as I see it. He doesn't "work at the breast" to
drain it or he doesn't "get it" , that he can get milk at the breast if
he keeps going. Have suggested compressing while nursing, different
positions, switch nursing, marathon in the bed, power position on the
floor. Am open to any and all suggestions, paricularly, how to teach the
baby that the food comes from the breast. Thanks for your help
--
Anne Andrianos, MS,RN,IBCLC
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http://web.syr.edu/~afandria/
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