I was hoping for some input on this one.  Of course I have permission from 
mom to post.
2nd baby, the first one we never got to breastfeed- she just would never 
latch for longer than a minute or two.  The mom pumped for 12 months.
And boy did she pray things would go smoothly this time around.
This baby is a boy.  Normal, natural delivery.  Baby had trouble initially 
latching.  I was hoping I would just come for a minor latch problem- but no. 
I saw the pair on day 3 1/2 when they had just come home from the hospital. 
Mom was trying to nurse and then giving another ounce of formula afterwards 
because baby was so hungry.
She tried to latch baby on, and the baby did nothing.  There were miniscule 
flutter sucks, but no milk transfer.  The mom was able to pump out 20-25 cc 
after each nursing session, so she had some milk although the breasts were 
quite flaccid.
I tried the baby with a FF tube with some of her pumped milk to see if I 
could elicit a good rhythmic suck. The baby did beautifully once the tube 
was inserted.  Long draws, good jaw movement, etc.  The minute the tube was 
removed, he stopped.
I left her with instructions to feed with the tube, use as much breast milk 
as she could get, formula as needed, and of course pumping.  Now it is 3 
days later.  Baby still will do nothing without the tube.  Mom is afraid he 
is getting addicted to it, and will never nurse without it.  On the other 
hand, he is still not transferring milk without it.
On her discharge papers the doc wrote minor head lag.  I felt that his neck 
muscles were quite weak.
I am unsure who to refer to- CST?- what is the next step.  What are reasons 
that he would transfer close to nothing, when with the tube he does manage 
to get some breastmilk out also?
My heart just goes out to this mom, based on her first experience.
Any thoughts or suggestions?

Jessica Billowitz, IBCLC
Israel 

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