Have permission to post by this mom who I am in a quandry about. Baby is 21
days, full term, bth wt 8-5... lowest wt 7-13... wt today is 8-13. This is
the first I have seen of this baby though mom came by and rented a Symphony a
few days ago. Baby looks good, is peeing, pooping only 3-4 times a day,
seedy and yellow. Parents are giving supplemental bottles of EBM about 2 times
a day when baby is inconsolable and hungry. Mother has well developed
breasts, perfect nipples and areola size, protruding, etc. She had a very good
milk supply but it is dwindling. If she doesn't pump at night, she winds up
leaking all over her nightgown. Baby latches on okay but doesn't do much. She
sucks for a short bit, not a whole lot of swallowing, sleeps on and off even
when cued, breast compression et al. Her chin is somewhat recessed. Her
frenulum is not clearly tight as it seems a bit far back, but her tongue does
not go up to the palate when she cries, rather it curls some or stays in
center, but not up. She did not take kindly to my gloved finger in her mouth.
Would not suck with finger feed enough to get milk through #5 French tube.
Would not suck hard enough at breast for same. Mother hates idea of SNS and
would not purchase it. I rigged my #5 French version but the stiffness of the
tube seemed to bother the baby. Even when she did keep it in her mouth and
finally after forever tries, pulled the milk down into her mouth, she did not
respond vigorously at all, just the same. When I shot some milk into the
corner of her mouth with periodontal syringe, this too did not stimulate her
suck. Mother is very obsessive about figures and record keeping with meticulous
charts of nursing times, bottles fed, outputs, etc. She pumps on and off
through night when baby does not nurse. She sits up sometimes waiting for baby
to wake and always sits upright to feed, not laying down. I did show her
side lying and I thought the baby was a bit better at sucking that way. Tried
size small nipple shield and it went okay -- not great in that it took awhile
for baby to pull enough to get milk into shield tip. It was no miracle cure.
I have suggested to parents that they check with ped to evaluate possible
tongue tie, but who knows where that will go. I doubt it would be correctly
diagnosed and/or that they would allow clipping The odd thing is that there
is no nipple soreness, which seems to usually coincide with tight frenulum.
Baby is always wanting to be at breast, though when they bottle feed her she
sleeps longer and when they used formula, well - she slept all night! Mother
is taking Fenugreek which ped told her he never heard of!
In the two hours I was there, between tubes, syringes, finger, and breasts,
she took 3 oz. but it was a marathon.
I am humbled here as I am coming up dry and not able to figure out what to
do. Oh Smart LCs of the World.... your thoughts? Thanks, Ann
Ann Conlon-Smith, IBCLC
Triangle Lactation Consultants
_www.trianglelactation.com_ (http://www.trianglelactation.com/)
"Prayer does not use up artificial energy, doesn't burn up any fossil fuel,
doesn't pollute. Neither does song, neither does love, neither does dance."
Margaret Mead
"Neither does breastfeeding," ACS
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