Esther wrote"

<baby would often pull off =
screaming, then suck her fingers.  This continued for the 1st 6 months.
=
STILL sometimes pulls off choking & coughing.   Baby refuses to nurse =
when the least bit distracted, seems to love solid food and while she no
=
longer screams and pulls away,  she does not seem to rely on BF for =
pleasure or comfort>

The baby seems to have suffered insults to the airway for so long from
OAMER that she must have very deeply engrained aversive reactions to the
breast to protect herself from the "firehose" effect.

I doubt it's possible to overcome that completely at this point, but
consistent use of antigravity and neutral gravity (lying down) positions
might help some.

Also hand triggering the MER first, and waiting a full 5 minutes for the
surge to subside before latching would also slow the flow of what the
baby receives.

<She has tried nursing a "couple of times" in a row on one =
side with no effect.   She works part-time & pumps often there,  and =
even at home she is often resorting to pumping to keep ducts clear (has =
been given conflicting advice about this)>

Sounds as if conflicting signals are being sent to the breast. The more
she pumps (and leaks during MER when baby is backing off), the more the
breast thinks is being used by the baby. So, the more the breast
supplies! Some will advise herbs, etc., no doubt, but allowing the milk
itself to send the right feedback to the alveoli and doing so
consistently seems important to consider.

While she may well have to pump on the opposite side to prevent plugged
ducts, very very gradually reducing the amount over time, to bring her
supply into balance, I would suggest that she consistently use one side
for all feedings building up to 6-8-10-12 hours. Dr. Newman even mentions
one mother who used one breast for 24 hours, and the other the next 24
hours.

After the condition is under control, perhaps taking this process slowly
for as long 2-3 weeks, she might once again consider alternating sides a
little oftener, observing the reaction of the breast as she does so.

Gonneke earlier suggested that a good way to start this process is by
pumping both sides as thoroughly as possible to begin with.

Or the only other alternative might be to nurse 2 babies! Wet nursing?
New pregnancy, tandem nursing???

Jean
****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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