Hi!  I'm new to the site and hope somebody will be able to help/suggest.  Last week I worked on the Labour & Delivery unit of our hosp.  A baby girl was born @ 35 wks and she was missing her Rt. ear and had an asymmetrical jaw (rt. side).  I was asked to assist with br.fdng. as the baby was having difficulties.  She was making every effort to latch but was unable to maintain it.  Her suck was quite weak when assessed.  She fed fair as long as I compressed mom's nipple & held it for her.  She spent only a few hrs. in NICU for obs. & was then transferredf to the norm. nursery.  Two nights later, I was working on the post-partum unit and had this M/B couple as part of my assignment.  The nurse on the evening shift had developed a br.fdng. plan which involved using the SNS & having mom pump after the feed.  As the baby was preterm her requirements were 30cc q3h.  There had been a consult. placed to genetics.  They stated she had a manibular and poss. maxillary hyperplasia and Rt. ear dysplasia.  No definite dx of a syndrome @ this point.  It was suggested mom attempt brfdng for only 15-20 mins/feed so as not to tire baby out.  A 30cc syringe was taped btwn mom's breasts & a 15" #5 feeding tube was taped to the nipple. Mom seemed to manage well with this.  Baby latched & the suckling had definately improved since I had seen her after birth.  She still tended to slip off the nipple, esp. as time @ br. increased.  She even seemed to be gasping for air, though not occurring  consistently.  She was able to relatach.  The feedings did take longer than 20 mins. Mom then pumped approx. 10 mins. but was discouraged at the little milk vol. she was obtaining.  I suggested to the nurse coming on to the day shift they weigh baby AC/PC  to see how well baby was withdrawing br. milk.  I was not there the following night & am unaware of how well baby was doing etc. Has anyone encountered this before and I wonder if the difficulties were R/T the prematurity, the jaw, or a combination of both?
                Thanks, Bonnie

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