In a message dated 2.15.03 6:20:49 PM, Kristine writes:


> >>Her first baby was failure to thrive but started thriving with formula
> supplementation. She breastfed and supplemented until baby was 6 months.
>  Despite wide nipples, mom latches him well and nipples are
> not pinched or flattened when he comes off
>  He starts out very alert when in his nutritive phase
which only lasts about 5 minutes per breast (with a 1:1 or 2:1
suck:swallow ratio). She switch nurses and he has another brief nutritive
phase. After that, his eyes are closed and he changes to 5-6 sucks per
swallow. Then, mom can pump 1.5-2.5 oz.<<

Very interesting case,particularly when it has many similarites to a recent
one of mine!
What made my case particularly interesting was the fact that this was Mom's
7th child!
She had breastfed the first 4 (1st marriage) longish term w/o difficulty.
With the last 3 (different father) she has had difficulty with poor wt gain
with all 3. She noticed a difference in suck strength and physiology with all
3 but didn't have the knowledge of techniques to effect this.   I worked with
her to use many of the techniques that you have described, in particular,
helping her to become comfortable with AND use the f-ball hold (how many of
our Moms say they *hate* the f-ball hold!), familiarizing her with swallow
detection and promotion ie. proper positioning of breast to baby, use of
massage, using 4 positions per feed but shortening total feeding time.   All
of this did allow for 1oz/day wt. gain but despite my assurances baby
required *many weeks* of this exhausting attention to detail, not at all what
Mom bargained for but she hung in there and 2 mths later finds him improved
but still not a self regulating nursing baby.
A truly fascinating case in terms of the added dimension of being able to
compare to previous nursing experiences. My guess is that the last 3 babies
had differences in their oral anatomy that precluded an easy, effective
transfer of milk.
I agree with previous posters in terms of oxytocin use, I don't think it
would help at this point. Your Mom is pumping alot more milk than mine was
able, thus the techniques you have been using plus some of the above
(assuming you haven't been using them!) should make a big difference.
Good Luck!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts



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