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Subject:
From:
Sharon Knorr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 30 May 2001 17:12:10 -0400
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Pat,

A couple of quick thoughts.  This is a case where I would use switch-nursing - as soon as the MER starts to trail off on one side, switch over to the other, and then back again.  Augment with breast compressions.  Also, I would get this baby off of everything except the breast and the SNS.    To use the SNS properly for suck training, baby should only get a flow when he is deeply latched and sucking reasonably well - keep the tubing pinched off if the baby is not sucking correctly. You can also experiment with tube sizing.  Make sure that baby is not just sucking on the tubing - experiment with placement on the breast.

If baby simply will not suck well at the breast at all no matter what, then I would suspect that he has become attached to the feeling of a a "stiff" nipple in his mouth, be it pacifier, bottle or finger.  I would go to a nipple shield as an interim device, possibly with the SNS tubing threaded underneath if extra supplementation is still needed.  Once baby is feeding well at the breast with the shield, then you can go on to the next step of weaning off of the shield.

Hope this helps.

Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

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