I saw a mom, dad & baby yesterday that are having problems.  Baby was
born 9/21, birth wt = 8-11.  Discharged from hospital 9/23, wt = 8-0.  Wt at
Ped's ofc yesterday (9/25) was 7-15.  Baby has still never latched on
effectively!  LC at hospital set mom up with syringe to avoid nipple
confusion.  Baby is VERY sleepy.  Mom always tries to latch baby on, but he
either falls asleep or gets frustrated and cries.  Mom then pumps (manual)
and offers EBM via syringe.  Has given ABM via syringe x2 in hosp, and x2
since discharge.
     I observed mom & baby yesterday, baby was alert, but clearly not
interested in nursing.  Encouraged mom to be more patient w/latch-on. Finally
got baby *attached*, but wouldn't suck.  Mouth was wide open, lips flanged,
etc--everything *looked* good, except not sucking.  Mom's milk came in 9/24,
and she was still engorged.  She pumped some from both sides to soften
breast, but same response from baby.  Have been using syringe orally, with
tube on finger, and tube at breast.
     Mom had epidural, but otherwise normal vag delivery.  Had 4+ wet
(disposable) diapers yesterday, and 1-2 stools/24 hrs.  Mom says
greenish-brown.  Using cradle hold, and most of the time is good, but
discussed technique.
     Thought that maybe baby wasn't putting forth the effort to latch-on
since he would get syringe fed after short attempt at breast. Enc. mom to
wait until baby was hungry, and be patient to learn latch-on.  Tried
overnight, but baby still fussy until syringe fed.  Mom is motivated to BF
and I am going to give her an SNS this afternoon to at least keep baby at
breast.
     ANY comments, suggestions, etc would be very welcomed!  I don't have a
lot of experience with this situation, and figured Lactnet would help!
 E-mail me privately if you wish!  TIA!

Sandy Arnold (IBCLC hopeful!)
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