Hi - I've been lurking for several weeks and now have a problem that I'm
hoping to get some help on.  I'm a CNM in a small town where there are no
professional LCs, so we get to solve most nursing problems ourselves.
Yesterday I saw a client who has a 6 month-old baby, one of those kids you'd
probably call demanding or high-need.  His sole source of nutrition right
now is breastmilk - his parents have recently tried a bit of solid food and
think it makes him even more fussy, so don't want to try again for awhile.
The problem is that this baby doesn't sleep unless he has mom's nipple in
his mouth.  They have a family bed, so the baby spends all night nursing,
with mom waking occasionally to change sides because her nipples get raw -
actually, they don't get much sleep at all.  He nursing fairly often during
the day, and at his two main naptimes during the day, the same thing happens
- mom has to stay in bed with the baby and keep him on the breast or else he
wakes screaming, she says.  She had an abusive childhood, is emotionally
fragile,and determined that she will meet her baby's needs and not ever
leave him to cry it out.  Yet she is totally exhausted, and to make matters
more complex, she is already 3 months pregnant with her second child!  I
talked to the parents about the risk of "bottle mouth" (milk mouth?), but
they feel pretty trapped in this situation because they don't want him to
scream, especially all night.  Please, someone give me some help with this
situation!  (Incidentally, the baby weighs about 19 pounds and appears to be
well-fed.)

Gretchen, CNM