Just had a case of an 18 yo G1P1 with an excellent milk production whose baby
would not latch on for more than a minute or so, then pulled away screaming.
Willing to drink mom's milk from dropper with no problem

First telephone call discussed ways to latch on using baby on top, letting baby
latch on, and other "overactive lettdown" suggestions.

Second call, the next day,  baby had not stooled in 24 hours - immediate visit
scheduled.

 At first visit, baby had lost over 10% of birthweight, so we did not
concentrate on latch-on, but rather on "feed the baby." Grandma very supportive,
willing to use medicine dropper (not comfortable with cup or syringe) feeding.
Only way baby would nurse is while mom was walking around, and even then for
short times which ended in screaming and arching until mom would cry with
exhaustion.
Second visit,  4 days later and 5 oz weight gain, they returned to me.  Mom said
she's had it, will stop bf if baby cannot breastfeed without screaming.  Watched
baby latch on, suck, then observed arching and pulling and screaming when other
breast began to "pour" milk out.  Tried pumping prior to latch on, but MER's
still very strong sprays. Well, thought nipple shield might slow the spray, not
frighten baby so much, give baby more control.  Latch-on was good, baby's body
relaxed for the first time at the breast and stayed until full without arching
or screaming.  Mom was in tears as was Grandma.
This baby never had a single bottle.  Not nipple confused.  Suck evaluation
showed good rhythm and suck-swallow felt totally normal.

I feel very defesive about turning to a nipple shield, but this seemed the only
solution that would keep mom nursing while we worked on other solutions.
Perhaps I created a new problem, though I doubt very much I'm damaging  mom's
milk supply more by using a nipple shield than by mom's having to pump
continually as baby would not nurse.  Perhaps we'll even be able to reduce the
supply to a more manageable amount so baby can handle it.  Perhaps she will grow
up a bit and be able to handle the strong let-down later on.  However, the
choice, I felt, was either give them hope that things will get better or have a
mom wean today.
 We will have a weight check in 3 days, mom to monitor diapers and stools, etc.

Comments?  Suggestions?

Jeanette Panchula, BSW, LLLL, IBCLC, RN
Puerto Rico - HOT
[log in to unmask]