Anna wrote:

"Thanks to all for your feedback. Would swallow/suck difficulties explain 
her
aversion to the breast, though?  We've all seen ineffective feeders who are
happy to starve at mom's breast. This baby doesn't want to go there--will
maybe latch for a second, then start to fuss and resist 'being there.' The
mother wisely lets baby set the pace and doesn't try to force it, but I
wonder if the hospital experience of being forced onto the breast, plus no
milk yield for 4 days, caused this. The longest baby has nursed since d/c
has been maybe 2-3 minutes."

Here's my too long of an answer: something is wrong, obviously, with a baby 
who can't or won't breastfeed. It is normal for babies to breastfeed. Could 
it be from being forced at the hospital? Maybe. Suctioning can cause 
problems with oral aversion. I have seen deeply suctioned newborn babies 
refuse to swallow -- period, breast and bottle-fed.

I have never seen a 100% breastfed baby refuse the breast because of low 
supply but I have seen a lot of tense, arching babies. What I mean is that 
if baby has been latching on with some milk transfer, and no bottles, they 
will not refuse the breast because it is the only feeding method they know. 
They may fuss alot after the milk is gone. I would also expect a newborn who 
is not transferring milk well to get very quiet, difficult to wake up, and 
with a too large of weight loss by day 4. Sometimes they scream alot before 
getting to the quiet stage.

I have seen plenty of archers and fussy ones who seem to be too tightly 
wound. Arms and legs are really tense, usually the mouth area is tense also. 
Typically bottles get introduced early in these babies and they tend to 
refuse the breast after getting bottles. I don't look at this arching 
behavior as "breast refusal" because if you watch them they do it other 
times, too. But, the mom always thinks her baby is refusing the breast and 
pushing away from her ON PURPOSE. The last arching baby I worked with was 
doing it as I bottle fed her and this made mom see that the problem wasn't 
breastfeeding.

Sometimes it is not the mother but the baby who created a poor milk supply 
by being latched with no active sucking and milk transfer (from medications 
given for pain during labor and delivery, being a bit early, etc.) or having 
oral motor issues that interfere with proper milk transfer.

Here is an example of how a SLP might help: let's say baby has a too strong 
gag reflex and this is why baby arches away from the breast. Nipple goes 
into the mouth and baby reacts badly. With bottles, a mom can let baby tip 
suck without putting the nipple all the way into his mouth. This might 
"solve" the problem temporarily but didn't cure the baby's oral issues.

I am currently helping a mom who is seeing a highly skilled SLP, or OT, and 
this baby was arching alot at the breast, and couldn't hold a lip grip. Poor 
weight gain. The SLP or OT told mom how to hold baby that minimize the 
arching and help baby stay at the breast and do a better job. (I need to go 
see for myself what mom was taught to learn more.) The pediatrician thinks 
the arching may be related to reflux and a medication is being tried.

The other thing that occurs to me is that the mom saw a CST -- you mentioned 
something about the mouth being checked but I wonder if the body was ever 
checked? I have had a CST tell me she noticed certain things on babies not 
relating directly to the face, like tightness in the area that indicates 
stomach problems, the neck being out of alignment, etc. I would have liked 
to see this baby as a newborn and see how tightly she held her arms and neck 
and mouth. I have seen some really stiff babies (even after a good nursing 
session when their arms should be limp they still have tension in them).

Boy, some of these babies are a real puzzle but we learn with each one.

Kathy Eng, BSW, IBCLC 

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