This is a plea for information from any of you who have experience with
chiropractic care and/or CST as an intervention to help newborns who are
having breastfeeding problems.

Please consider the following case: 18 day old baby boy, full term. Labor
was induced with pitocin. He was delivered with forceps "sunny side up"
(posterior). I never saw this baby until this consult, so the history
prior to that is from the parents. He had noticeable molding & caput for
at least one week. He never latched on in the hospital. The staff tried
using the SNS & all kinds of positioning changes and finally sent her
home with a breast shield. She was also pumping and finger feeding.

His birth weight was 6#4oz; lowest weight was 5#9oz; weight at 17 days is
6#0 and has not gained or lost for 5 days. Mother says he breastfeeds
every 1 to 1 1/2 hours for 10 min with the shield. She has tried to wean
him off the shield without success. Her baby's care provider told her she
has to feed baby 2 oz of soy formula after every breastfeed (he never
observed the baby at breast or assessed her breasts)

When I saw this mom and baby, he looks very thin, but has
good tone, alert, moist mucous membranes, appropriate licking & rooting.
Observed them breastfeed (tried all kinds of variations of football &
clutch holds on right & left breasts). Baby makes a good deep-appearing
latch, takes 3-5 sucks & pulls off. Mom expressed some milk into his
mouth and also compressed and massaged her breast just prior to latch on,
but he still wouldn't stay on. I watched them breastfeed with the shield,
and he didn't even draw her nipple or any breastmilk into the shield when
he sucked. Next we tried the SNS to see if milk flow would keep him
latched on, and same story--maybe 5-8 sucks at most. He just didn't seem
settled or comfortable at breast, but he never cried or resisted or shut
down. Finally mom finnger fed him and he took almost 2 oz over
about 15 min-no problem. The other problem is mom's milk
supply is really low-she was able to pump 10 cc from both breasts (this
was pumping with electric pump+warm moist heat to breasts+massage &
breast compression). Mom is, of course, heartbroken, feeling guilty,
desperately wants to breastfeed.........

My dilemma is this. I have never been to a chiropractor so I don't know
much about chiropractic care or cranial sacral therapy. I have heard that
this may be helpful in some infants who have breastfeeding problems.
Would posterior delivery, use of forceps, head molding & unsettled
behavior at breast be indications? I'm thinking that, if mom's reduced
milk supply was the cause of baby's not staying latched, then increasing
the milk flow with the SNS would have helped him to stay on (he actually
did some audible and visible swallowing at breast with the SNS).

Could anyone suggest where this might fit into the decision tree/ plan of
care for this type of situation?

I did recommend the usual interventions for low milk supply/ latch on
problems, including q3h formula supplements (at breast if possible) until
mom's milk supply increases. Since this family does see a chiropractor, I
suggested that they discuss this with him and ask if he had any suggestions
(This was not a professional referral). When she went to the "weigh-in"
today, she somehow mentioned the chiropractor to the baby Dr (a D.O.) and
he went ballistic. He says the baby needs to go on formula
PERIOD!!!!!!!Still no observation of feeding or assessment of her
breasts.

I'm looking forward to hearing anything that will help me become more
knowledgeable about the place of chiropractic care in breastfeeding
situations. Thanks!

Amy Mueller, BSN, RN, IBCLC
Traverse City, MI
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