Hi Jennifer,
If the mom is able to lie down on her side, try and see if baby won't open his mouth more in that position. In my experience, in the positions where mom sits up, the baby's head and neck get a lot more bending/suspension/traction. In sidelying mom lies on her side -- completely flat, with pillows only under her head, not lifting the shoulders at all -- then baby lies on his side facing her. The baby has way more head and neck stability in this position, and often will open his mouth wider and actually feed. The mom may feel less in charge sidelying, but I explain that once her baby has recovered from the birth and gotten some skills at breast he will feed for her in ANY position.
If mom is pumping as much as 10cc (I agree this is great for 24hrs with all the factors you mentioned), try drawing the colostrum up in to a syringe and attach a 5Fr feeding tube. slip the end if the tube into the corner of baby's mouth and give him a bit of "bonus". This might be the incentive he needs.
Of course you have a 36 weeker to contend with and that may be the main cause of his being disorganized at breast. Good luck!
Martha Johnson RN IBCLC
Hospital based LC
Eugene Oregon
USA
-----Original Message-----
From: Jennifer tieman [mailto:[log in to unmask]]
Sent: Wednesday, February 18, 2004 8:12 PM
Subject: Bottle feeding to support breastfeeding
I'm wondering about when supplements are necessary for an ill baby who can't
come to breast. I'm currently caring for a 36 weeker who's mom had
pre-eclampsia. This little guy was depressed at birth and was briefly
intubated. He's just over 24 hours old now. His mom is interested in
breastfeeding, but he so far just sleeps at breast and won't open his mouth.
Mom has started pumping and is getting small amounts of colostrum (actually
about 10 ccs per session, which considering she is very edematous, still
getting mag, and completely worn out from a difficult delivery I think is
pretty good.) The nurses report he's sleepy with a bottle, too, but if they
poke the bottle into his mouth he sucks okay and is taking 15ccs or so per
feed. I have encouraged them to try some of the techniques mentioned to
support behavior he'll need at breast. Any ideas for how to get him to open
his mouth at all to start a feed? And is poking the bottle nipple into his
mouth (the only way so far to get the nipple into his mouth) teaching him
bad habits he'll need to unlearn later? Would an alternate feeding method
be better until he is more aggressive and stronger?
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose 5/31/03
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
--------------------------------------------------------
This message is intended solely for the use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential, and exempt from disclosure under applicable state and federal laws. If you are not the addressee, or are not authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the information contained herein. If you have received this message in error, immediately advise the sender by reply email and destroy this message.
--------------------------------------------------------
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
