Dear Lactnetter's,

I have been working with a mom of a 5 wk. old.  He was born at 37 wks., was readmitted to peds after discharge for jaundice ( 19 ), was tongue tied with a little more of a receeded jaw than babies usually do.  Mom had sore, bleeding nipples.  I stepped in during that readmit and helped with latch and information on tongue tie.  Mom at the time had milk dripping everywhere. Latching became better and after discharge, the baby's tongue was clipped. Parents took the baby in to the ped at 3 weeks because the baby all of a sudden wanted to eat like crazy,  nipples were sore, her breasts were really soft and there was no difference before and after feeds.  Baby would pull off the breast and cry. Weight gain was nil in one week.  MD advised formula supplement which made things go from bad to worse.  The baby went through all the formulas and is now on Nutramigen and breast. Lots of  crying, crying. Tried Mylicon gtts to no avail. The formula hasn't helped this baby's disposition at all and mom is looking to increase her milk supply.  Mom called me because the baby cries so much, he never eats and falls asleep peacefully. Once he's put down he wakes screaming.  Latching well is still a challenge due to his lower jaw and we worked on that more. He sleeps best when on mom or dad or near them in bed.  He has a hard time napping for an extended period during the day.  He seems to want to eat every 2 hours mom says but isn't settled after he does. He never just eats and goes to sleep. Bottle feedings didn't help at all.  Mom had stopped direct breastfeeding to allow her nipples to feel better and pumped for 24 hours.  Mom is using the SNS now to provide comfort for the baby, increase her supply, provide her milk and take a step out(bottle after breast).  She was able to pump over the weekend and put that milk in the SNS but since, hasn't been able to because of his feeding frequency.  She offers the breast for comfort also.  He did better with the expressed milk in the SNS but is still not happy.  I discussed Domperidone with her as a possibility  to increase her supply.  She tried More Milk tincture which didn't help. The baby is stooling in appropriate amounts and is gaining weight now. No vomiting. I suggested that she see the ped. before her next scheduled visit which is in Oct.to assess the baby.  I will also talk to him tomorrow.  Mom doesn't drink milk or seem to have anything in her diet that would cause such a dramatic effect on her baby.  She will also try a sling or front carrier with him during the day.  Although these are first time parents, they are calm and work very well with their baby.  I've seen the crying first hand and it isn't pretty.  Is there anything else I can suggest to this mom?  

Laura Walker RNC, IBCLC

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