Please help me help someone (updated)

[mariag]

I am going to meet with a "friend of a friend" tomorrow and hopefully offer some help. From what a know so far she has a four week old baby born at 36 weeks. She spent 5 days in NICU for jaundice and was given bottles and a pacifier. Since then the mom has tried to latch but couldn't do it and has only sporadicially tried for the last week. She pumps every 2-3 hours and has been giving baby bottles. She feels like her supply is starting to go down.

My plan is:
-have her start taking fengreek
-help her get baby latching (I hope)
-offer support

I would really appreciate any/all advice from anyone who has been in this situation or has something to offer. I've helped lots of friends and family, but never in a situation where baby has essentially not nursed for a month so I'm a bit uncertain how to go from bottle to breast....
thanks in advance.
maria

[wildmonkeys]

I have a good friend who couldn't get her son to latch on until 6 weeks - she pumped and gave bottles the entire time and then they finally got him on and established and she nursed for awhile. I also have a friend whose sister had her baby really early and he was in the NICU not nursing while she pumped and then they had an extended nursing relationship (til 2-3ish) So it can be done - I would encourage her to get support from a lactation consultant that helps moms of preemies transition???

BJ
Barney, Ben & Patrick

[balancedmama]

My first rec is to get mom and baby relaxed, in a warm bath with each other. Mom can hold baby upright between her breasts, and let baby find the nipple on her own. Mom can gently support the baby as the baby goes to the breast (baby might bop around and root a little). Mom should try this at the baby's most relaxed time of day (no the witching hour) and when baby might be ready for a snack but isn't starving.

Other interventions:

At this point, you might recommend a nipple shield. While I'm not a fan of them, they are appropriate in some circumstances. When baby hasn't been on the breast for awhile, they can be used to the silicone/plastic feel of the nipple. She would want to express to get a letdown before putting babe to breast. She may also choose to offer about 1 oz. of milk first so baby isn't starving, or nurse before baby is extremely hungry.

You should also be certain that she's using a slow-flow bottle, and that they are pacing bottle-feeds (making baby work harder and not just dumping milk in baby's mouth).

Mom might also try a SNS or Lact-aid to give baby the instant gratification at the breast, which is probably one reason why nursing is not happening right now.

Good luck. I would also encourage her to go to a LC.

[mariag]

update: I went out with the mom and she is doing better. We worked lots on her latch (she has really large breasts and was just having trouble holding baby and her breast to get her latched), she is eating lots of oatmeal (she can't take fenugreek b/c she is hyperglycemic), and she is holding baby lots and having her sleep close to her at night (before she put her down as soon as she ate during the day and was in another room at night). Yesterday for the first time the baby latched on at the breast without taking a little ebm from the bottle first so she was pretty excited. I think baby is tongue-tied and has trouble extending her tongue out far enough to suckle well so she is going to see the ped today about that. She met with two lc (both of whom tried to get her on a sns type feeder but she just got stressed out after trying for a few days) and just didn't feel very comfortable with either of them (nor did they seem to really help her much). I should add that her husband is/was in the Marine Corp and got reactivated (he had been out for about two years) in Dec and will be away until November so she has a lot on her plate. Thus, stress is not good b/c she has so much all ready. She is seeing the benefits of co-sleeping but still a little leary. has anyone here used a "baby nest" that you put in your bed for the baby? A friend of hers told her about it but I have no frame of reference for that so couldnt' give her any feedback.

Anyway, thank you all again, I am hoping she can get things figured out and at least make it to 6 months, if not longer!

Maria