I wanted to update all of you on the current status of the baby I posted
about a couple weeks ago.  To refresh your memory, the baby had a deep
bubble palate, mom had a questionable milk supply and weight gain was an
issue.  Baby is now 7.5 weeks.

We have been working hard to track down actual causes vs secondary effects.
Mom experimented last week with stopping pumping, listening only to baby's
cues and trying to "get back in touch" with her baby.  First 24 hours were
great.  2nd 24 hours mom's milk supply had plummeted and baby was feeding
constantly and very fretful.

Mom went back to pumping and milk supply was back up within 24-48 hours.
She is experiencing fullness, MERs, etc which she did not experience first
few weeks.

Mom has had continuing concerns that baby sucks well for initial 2-3 minutes
then it is a struggle to get any suck much less a good one, baby will
swallow only when sufficient milk has pooled in her mouth (via p-syringe or
mom manually expressing into baby's mouth).  She feel like she is
continually force feeding this baby.

Early this week mom was utterly frustrated so I again gave her options.  She
wanted to try the SNS because the bfdg relationship is great, baby just
isn't getting enough to eat.  We tried and just as I was worried baby
couldn't get anything out of SNS either.  She actually was able to push air
back up the tubing after mom had been squeezing the bottle to force fluid
into baby's mouth.

Baby is due for an 8 week checkup and I want a really thourough evaluation
done.  I talked with the pediatrician about my concerns a week ago and she
basically felt that if the baby was gaining she wasn't too concerned.  Mom
called yesterday to try and talk with pediatrician who was on vacation.  She
connected with the on-call pediatrician who basically said give the baby a
bottle, ABM and breastmilk are the same, what's the big deal.

Yesterday they came and I looked really closely at baby's palate to rule out
a slight cleft that may have been missed.  No cleft, just a very high
bubble.  Mom has been wondering about bottle use all along so I encouraged
her to bring in a bottle and we'd try.  So we took a bottle with a NUK
nipple (6 month+ size) and gave to baby.  She took 1/2 ounces beautifully
and I was beginning to truly wonder.  Then all of the sudden her suck
changed and she began little ineffective sucks and swallowing only when milk
pooled in her mouth.  After 10 minutes she had taken a total of 2/3 ounce.
Exact same pattern she exhibits on breast.  Baby was more active at this
visit than at previous visits where she often looks like a rag doll when she
is feeding.  This visit she was able to push up slight when placed on her
stomach, she brought her arms to center and turned her head from side to
side.  I was glad to see that.  But the issue of stopping active sucking
after less than 1 ounce is really odd.

Any thoughts would be appreciated.  In the past with this post you have send
a wide variety of thoughts possibilities, etc.  I really appreciate all your
input.  It has been most helpful.





Denise Parker, BA, IBCLC (La Crescenta, CA)
To Avoid Criticism, say nothing, do nothing, be nothing