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Lactation Information and Discussion <[log in to unmask]>
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Wed, 19 Jun 2002 07:45:19 EDT
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OK, here's mine for the week -- uh, day.  These are the days that make me
want to open that bookstore....

Saw a mom in the hospital about a month ago, who shared that she didn't have
enough milk with her little girl, now three, so she supplemented and the baby
eventually "weaned" at 6 weeks.  We talked about preventing that this time
and getting in for a check if she felt as though her milk supply was
faltering.

When she called to see me (about two weeks ago) because the baby was "always"
hungry, and I evaluated her bf, her milk supply was marginal, but the baby
was sucking at the breast rather oddly.  Though he could maintain a latch, it
was almost as though he was using all the negative pressure in his mouth to
extract the milk like a straw.

She had been giving him a bottle, and when it was clear that he *was* still
hungry after feeding twice on both sides with maximal breast compressions --
etc etc etc -- she gave him some formula -- in an old Playtex nurser -- the
short stubby nipple kind.  Lo & behold, he's sucking on the rubber nipple
exactly the way he sucked on the breast.   I pointed this out to mom,
suggested that this was part of the problem, and that perhaps she'd like to
try a different bottle  to supplement while we worked at bringing up her
supply (not amenable to an SNS -- my first suggestion -- or a cup -- my
second suggestion) so that we could entice him to use his *tongue*
appropriately.

She came back in for a weight check yesterday.  He's almost 6 weeks old, and
he's gaining OK -- she's still supplementing, though down to 4 ounces a day.
When I asked her if she had switched bottles so that the sucking would
improve on the breast -- no, she hadn't.  I tried to explain (again) that
nipple confusion doesn't just mean the baby won't latch on -- that it can
mean that the baby doesn't suckle correctly at the breast.

Her response was -- "I'd like to start giving him more formula now."

Sigh.

Jan Barger, RN, MA, IBCLC -- Wheaton IL
Lactation Education Consultants
www.lactationeducationconsultants.com

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