Dear Lactnetters,

I had a mom come to me the end of last week with a challenge.  She is a young mom with good support from her foster mother.  Baby was born last Jan. at 28 wks.  He was a twin.  His sister died in utero at 22 wks.  She pumped til last May on a regular basis which is when Roman came home. She had many challenges with BF mainly because of the difference in support  she recieved from the hospital of birth which was great an hour away to the one here in town.  Anyway she has been pumping 2 times a day since May due to breast pain and just got tired of poumping.  Roman hasn't gone to breast since the Spring.  They are both now working with early intervention for feeding difficulties because of his suck making feeding a long process.  Mom has ADHD, has a terrible social history, is plugged into a lot of services from different agencies and is stressed trying to coordinate everything.  Roman is a very social baby, smiling, happy and very vocal.  Grandma says he may have mild CP and this is observed in his tone and movements.  The reason they came to me was that due to the feeding difficulties, the speech therapist and social worker wondered about breastfeeding again to help muscle development in his cheeks and improve suck.  He has no fat pads in his cheeks.  
From my observation with them, he doesn't do well being held too close for long periods.  Offering the breast makes him cry and push away because of course he doesn't know what to do with it.  We tried a shield and a tube to see if he would do anything which he did not. I think all involved thought this would be just a simple process and easy, just go ahead and breastfeed.  I'd love your input on this.  I don't have any experience with a baby like this and after all this time I know it will take time to make any progress here.  Mom said as much that if this wasn't going to be a fairly simple process, then she was going to stop pumping, offering breast all together.  From my perspective, I wish she had come sooner.  I suggested that they cuddle together skin to skin as much as the baby would allow to start and to try holding the baby close to the breast while bottle feeding.  Mom has been feeding the baby away from her body for the last few months, not sure if that is because of baby or mom keeping the baby at a distance.  Grandma seems to think it's the latter because when she feeds the baby close it's OK.
Thank you for your input.

Laura Walker, RNC, IBCLC

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