Thanks for the thoughts everyone!  I believe the receding chin is causing
the problem.  It is my hope that the baby will eventually adjust the chin
position and grow big enough to latch. For now, the parents are
supplementing and are most comfortable handeling bottles vs other feeding
methods.  Today the baby had stopped loosing weight (had been down 14oz)
and though we are still unable to keep the chin forward and get a latch
when attempting to breastfeed, she was able to maintain a seal on the
bottle (could not even do that yesterday).  Parents are also going to
contact a speech theapist for further suggestions on oral exercises.

I just wanted to clarify the supplement issue and why I suggested it (some
had suggested I jumped the gun).  The baby had not nursed at all..in the
first 2 days of life she was sucking her tounge...mom thought this was
nursing.  Mom and baby were going home, we discussed what nursing would
feel like, what to do to encourage a latch and began supplements of formula
as breastmilk was not yet avaliable and baby still have never latched and
therefore had gotten no nutrition since birth. I told the parents to keep
the amount small, keep trying to nurse every 2 hours or so and if there was
a sucessful latch to skip the supplement. I did not feel it would be
appropriate to encourage the parents to keep avoiding supplements at this
point because baby was now 2 days old.

Upon return visit (day 3 of life), the baby was down 14oz (birth wt of 7-8)
and still not nursing.  Milk still not in.   Mom unable to pump or squeeze
out any colostrum.  Only 1 15cc bottle had been given since discharge so
formula at regular intervals was suggested to prevent further loss.

Thanks again for your collective insight!


Thanks

Lori Peters RN/IBCLC

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