I cannot figure this out and need all of your help. I've been working with a
Mom and her twin girls. They were born at 35+weeks gestation. Started with
gavage feedings then went to breast and gav., then to breast & bottle
feedings, then to breast/SNS.They have always appeared to latch on well and
one has been very aggressive (IUGR) and one passive. They are now 37-38 weeks
gestation. They both get into nice long stretches of, what appears to be,
nutritive suckling but only occ. swallows heard. Pre/Post weights show milk
transfers of 2-15cc after 30-40 minutes of nursing (actively). One time the
passive one took 20cc and the aggressive one took 2cc when they were both at
breast at same time.
Mom has been breastfeeding, supplementing (with bottle when SNS not working
properly) and then pumping. She is determined but frustrated. Now there is
the added problem of decreasing milk production. She is taking Fenugreek.
Anyone have any suggestions? I'm wondering if this is just a maturity thing
or are we missing something? Please help, we will take any suggestions.

Kim Sweet RN, IBCLC
Phoenix

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