I have mother's permission to post. 

Her baby boy is almost 16 weeks old. He was born at 37-38 weeks 
gestation by caesarean section following a 17-hour labour at 2.73kg. 
Baby never established breastfeeding very well and at my first 
contact at 13 weeks (don't you hate coming in soooo late) he was 
having two breastfeeds per day with a nipple shield and 5 bottle 
feeds of EBM and or formula. 

He was taking about 1 hour to feed 60mls at worst or 90 mls at best. 
A Paediatrician had been involved already and he said to limit feed 
times to 3/4 hour. Under the circumstances I could understand why 
he said this but we looked at feeding efficiency at any one feed rather 
than the clock. 

When I observed baby I found him smiling, babbling and responsive 
so long as he was lying by himself with nothing to do. When he tried 
to eat in any form he became most unhappy and not surprisingly he 
wasn't and still isn't gaining weight! 

At the breast he was remarkable for the way he constantly moved 
with quite agitated movements of his arms, legs, head and body. 
Exacerbating the problems he was sleeping through the night and his 
measured milk intake was only about 500mls plus what little he may 
have transferred from the breast. 

Mother is now waking him at night however according to the father 
today he's taking only 60mls per feed on average despite initially 
doing better with the bottle pacing technique.

Sorry there'll be lots of gaps in the account above and breastfeeding 
is not the priority but please can you advise how and with which 
device, teat or whatever this baby can take more milk food?

Today father asked if feeding difficulties can be hereditary. He was 
referring to his own problems with what he called, closed throat. He 
didn't know if there was a name for it but he said he can't drink 
continuously. In other words he can't drink a glassful of fluid. He has 
to take one swallow at a time and he was diagnosed with a hiatus in 
his mid twenties. 

Any ideas gratefully received.

Marcia Annandale LLLL IBCLC
Christchurch, New Zealand

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