Consultations normally last for 2 hours, if case a bit tricky, upto 3 hours tops. But this was a total exception - 7 hours! Mother had flat nipples which made it even harder to latch the baby on. But the real problem is that the baby (after researching and reviewing my lactation management notes) was an aggressive non-nurser.
Consultation started with teaching the mommy how to do the nipple roll to make her nipples protrude. I also taught her alternative ways like ice, inverted syringe, the pump, etc. But even with the slightly protruded nipples, baby refused to feed (last feeding was 2 hours ago and baby was definitely hungry). It takes an hour of coaxing, coaching, soothing music, infant massage & more crying to decide he needed to get some milk inside. I asked mom to express a little then feed the baby from the breast, dropping milk on top of breast to trickle down to baby's mouth. This usually works but not with this one. He screamed to the top of his lungs and kicked and pushed the breast. For this session, we had to give him milk through a cup then when he was asleep, answered more questions of the mom and gave her more tips.
When baby woke up after about 1-1/2 hours, we changed diapers and clothes, to make sure he is comfortable, dimmed the lights a bit, put on a Mozart cd and attempted to breastfeed even before he asked for it. At first he was trying, 1...2...3 suckles then pushes the breast away. Try again....and again and again, until the baby is crying so frantically, mommy cries in the process as well. "Why is he rejecting me? Doesn't he love me?" I believe this is clearly becoming a case of "baby blues". I tried to calm mother first and tell her that although I have never seen anything like this yet, I have read about it and in time and patience, baby can breastfeed. I also told her I will not leave her side until I have latched her baby. But for this feeding, we gave baby a cup again so mommy can recover from her emotions.
After another 2 hours (and boy was it getting late, around 10pm), I realized I had to change the breastfeeding goal for the day and do a follow up. I asked her to try using the nipple shield just while the baby is learning how to latch so as to lessen the problems that we needed to address. Coax the baby to take the breast first. It was another 30 minutes of trying to latch on the nipple shield and pushing and kicking of her baby boy, before I finally saw 1 (suckling) ...2...3....4...5... stop. Then 1...2...3...4...5......8....9...10... stop. Then again 1...2.....6.....11.....20... and on. He stayed on the breast for a good 10 minutes, with very visible gulping and swallowing. Then breastfed on other breast for another 8 minutes. Baby fell asleep after.
I advised mom to use the nipple shield for another 3 days and saw her again on the 4th day. This time, baby was suckling very effectively already at the nipple shield. The next challenge is to take it out (direct breastfeeding still is best to stimulate supply). Luckily, it didn't take 7 hours to do so. Baby was more cooperative and was doing direct breastfeeding after 4 hours.
Baby is now 1y4m and still breastfeeding, rarely gets sick and is advanced with his milestone developments. Mommy said if I hadn't come to help or given up, her baby would be formula feeding by now and she would always feel like a failure.
This is what makes me continue what I do. Giving the babies the best that they can have and providing the moms their confidence!
by Abbie Yabot
No comments:
Post a Comment