help me help a client

[MamaRabbit]

I'm a new doula and have very little experience helping moms with breastfeeding. I did not provide prenatal education but she called me after the baby was born because I was the only one she knew of who could maybe help.

1st baby, 4.4kg (9lb11oz) via C-section. Nursery staff is giving bottles because the baby is so big that she *needs* more than the mom can give her. Nurses show a video to show a mom how to bf. Nursery staff won't provide the timing of bottles. I talked them into having the baby room-in the night before. Mom nurses (tries), dad gets baby to sleep after getting major burps and gas out of baby, nurse comes in 10min later and crams a bottle in the baby while mom is in the bathroom. :irked:

The baby will not stay latched for more than a minute at a time. Mom is starting to get sore. Does suck well once latched. At 1.5 days old can the baby already be that confused with bottle to breast? Mom does not want to formula feed but is so trusting of an incompetent pediatrician. I see colostrum leaking, so no question if things are starting up. After C-section, the milk comes in more like day 4 or 5 right? Also, the baby is latching on a well-formed nipple on the R side, but I notice on the L side that even though the nipple is kindof there, there's a slight dent in the middle. Could it actually be inverted? Could a shield on one side be of any help?

I apologized to them that I couldn't be of more help. Lactation training is something I'd like to do. They were grateful that they could learn the basic latchon tips and get reassurance.

What else can I do? I'll probably have a chance to see her at their hotel on Sunday. (did I mention that they're missionaries who flew out of China to have their baby in a safer place and have NO support?) I want to help her get off to a good bfing start because there is no help for her there. There is only ONE trained CLC in all of Thailand who will not come to a different hospital to help. So it's me or nothing :(

[mama in the forest]

Nursery staff is giving bottles because the baby is so big that she *needs* more than the mom can give her.

This is just bull!!!!!!! I have nursed all my babies fully without supplementing & they were all between 10 & 12 pounds.

First things first: she's absolutely got to insist NO MORE BOTTLES......none at all! She needs to exclusively nurse every single time babe needs to eat. Put babe to the breast as often as needed.

I would avoid a nipple shield on the troublesome side. Just watch her latch really well. Make sure baby is being brought very close to her, with babe's chest turned all the way towards her chest. Make sure babe's mouth opens very wide before nipple goes in.

This is her first.....there could be a lot of soreness & it could be normal. Many mamas are VERY sore the first few weeks.

Good luck!

[Kierdan'sMom]

Ditto no bottles. I'd tell the nurse that I was suing the next time she violated my choices for my child! Yes, they can get nipple confused that early. My son thought he should finger feed and it took gettting stuck without a pump and no expressed milk for 4 + hours to finally get him on. (At 6 days old) You're doing great! Most moms get sore, bring her some Lanisoh or something similar and maybe some Soothies to help with that and let her know thats its okay and will improve!

[tash11]

repeat: NO BOTTLES

sometimes getting a newborn to latch is difficult, espeicilly once she gets engorged. My LC told me to squish my breast to make my nipple a little flater and easier for my baby to latch on to. Some people call it the pankcake or the sandwhich hold. The sandwhich makes sence because you are holding the breast the same way you would hold a big sandwhich that you were trying to eat. You cant just stick a big sandwhich in your mouth, you have to squish it, and then roll it into your mouth starting from the bottom. I have my fingers close to the bottom of my areaola near where her chin will be, and my thumb also close, nearly on my areola near where her nose will be. Then I roll my nipple into her mouth starting from the bottom, she will do her job and latch on once she feels my nipple in the right spot. My description isnt that good...

here is Dr Sears info on it (http://www.askdrsears.com/html/2/T021000.asp)

and LLL (http://www.lalecheleague.org/llleaderweb/LV/LVAugSep00p63.html) (look at the asymetric latch)

I know there were some good videos posted here a while back. Does anyone know where they are?

[silverfern]

I had my ds after nearly 7 days of on and of labour ending up with a csection. I couldn't feed him myself because e was "too big". At this point I told everyone exactly where to could go and carried on nursing I had a nice nursing pillow for my arms to rest on whilst holding babe and he was constantly next to a boob for the first 3 days of his life I had my milk come in at the end of day 2/beginning of day 3 and showed them how wrong they where. I think especially in those first days its so important for mum and babe to be together all the time. So no bottles and lots of skin to skin contact I'd say.