I had a good day in the clinic today and just thought I'd share.

I saw a mum two weeks ago whose baby was 12 days old and 19 oz below BW.
Dr had sent her to our clinic for a weight check. Mum had given 1 oz of
formula in past 24 hours by finger feeding. Diapers not appropriate for
age.

Bf'ing assessment revealed soft breasts, no swallowing, ineffective suck at
breast with no improvement with a SNS and poor suck with finger feeding,
distressed with cup feeding and a mum who thought baby was swallowing when
she saw movements in baby's throat.

I suggested trying an Avent bottle at the next feeding, some suck training,
chin/jaw/cheek support when feeding (whichever helps baby get a good rhythm
going) putting baby to breast 8-12x per day for short periods until
swallowing is consistently heard, breast compressions, skin to skin,
renting a pump and pumping after feeds & once at night and considering
herbs to increase supply.  She left to get a pump and with knowledge of
appropriate diapers, a goal of 22 oz/24 hours if not swallowing at breast
and awareness of what swallowing should sound like.

Mum was to return to the clinic but didn't return until two weeks later -
today.

Baby had gained almost 2 lbs in two weeks! Baby is going to breast and
sucking well.  She is exclusively giving breastmilk and baby gets one
bottle of expressed milk in the evening by dad so mum can get a break.  She
is taking the pump back.  Mum was thrilled with the gain. Hopefully she
will give up the evening bottle too.  I am tickled pink.

I know it happens all the time but I just get such a kick out of each one
of these cases.

I have also "fixed" two other babies this week in 3 minutes flat with the
Charm Hold.

Janet Vandenberg RN, BScN, IBCLC
Ontario, Canada

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