Jaye,
We all do the best we can with the information we have at
the time. Yes,
the first rule is "feed the baby". She is doing
that even if baby isn't taking
the "required" amount.
What about the approach of "re-training" for oral
aversion? Maybe some oral
games with toys or fingers? If problem is with baby's mouth
refusing food
then mom might not feel criticized. She becomes the one who
can fix the
problem. If baby weren't eating at all or was listless etc.
then baby would be
FTT and hospitalized. Not that we want that to happen but
it doesn't sound
like this kid is going to let that happen either,
regardless of force feedings.
Force feedings are making the situation worse, obviously so
the trick is to
get mom to see an alternative.
My nephew and his parents have had feeding issues for years
(he is now 12)
and he refuses to eat more than about 12 items (which
include french fries,
chicken bananas etc). Things got so bad that he when he was
sick at age nine
with normal flu he lost so much weight he was hospitalized
for several days.
This has nothing to do with food and everything to do with
control. When my
husband and I took him with us for dinner (with our kids,
younger than he is)
and told him he could not order his normal dinner and had to
try a bite of
everything everyone else ordered he said he was going to
call his dad. We
told him we would call his dad for him. He didn't really
want to do that after
all! AND he ate three or four new things he liked (ribs
and shrimp among
them). I was worried his mom would be upset but she gave
me the silent "thank
you" over his head as he related his food adventures
to her. This is NOT the
situation your mom wants to be in. By making this an
"oral aversion" /
behavior issue SHE can fix so that the long term is better
you empower mother to
change the cycle.
I would phrase this to mom as a behavior issue. Baby is
learning that he
has control over mom, it's not about food. Yes, baby has to
eat. Yes, it's
nerve wracking when baby doesn't eat. But the long term
focus is to make
breastfeeding (and subsequently solids) enjoyable for BOTH
mom and baby. We don't
want baby to learn (or keep learning) that feeding is a
struggle and power
play. Sometimes changing the approach from "feeding
issue" to "development
issue" helps mothers see the long term effects of
their actions rather than
focus on the short term results they are frantic to
achieve. Babies who are
starving are listless etc. She KNOWS her baby isn't
starving. Babies are also
not suicidal, as evidenced by the baby eating when he is
tired. Goal is to
increase baby's pleasure with eating. I would suggest mom
using SNS to finger
feed baby while baby is in a light sleep state. This works
very well
because mom is able to stim. suck reflex with finger and
get baby to eat without a
struggle. Baby can be fed this way without moving or
waking fully. If she
does this while baby naps and at night then she can relax
knowing he is
getting calories. If he wants to nurse during the day then
that is great. I would
also encourage a co-bathing session each day (or as close
to that as
possible). This is to relax BOTH mother and baby and bond.
NOT to feed. (Of course
if feeding happens, which is usually does that is great.
Many times I tell
moms, bathe with baby to help bond with baby instead of
worry. I don't
mention feeding so there is no expectation. At least in the
end you are both
clean!)
We all do the best we can with the information we have at
the time. Yes,
the first rule is "feed the baby". She is doing
that even if baby isn't taking
the "required" amount.
What about the approach of "re-training" for oral
aversion? Maybe some oral
games with toys or fingers? If problem is with baby's mouth
refusing food
then mom might not feel criticized. She becomes the one who
can fix the
problem.
Not the most coherent post ever, suffering from jet
lag...just returned from
Asia! But I hope there are some things that help you.
Best of luck!
Warmly,
Christie Pillado
Motherhood Intact
El Paso, Texas
Date: Fri, 3 Nov 2006 10:53:38 -0800
From: "Jaye Simpson, IBCLC" <IBCLC BREASTFEEDINGNETWORK.NET>
Subject: Re: milk supply gone
Hi All,
To answer a few questions: Baby is NOT getting solids and
is not ready for
them - he pushes anything that goes into his mouth
immediately out. I think
this may also be related to the force feeding - not sure
exactly when that
started - sounds like it was last week but moms answers
don't always 'jive'.
I am trying to piece together a puzzle with pieces that
aren't always
fitting together correctly.
Baby nurses all night long - last chart showed feeds about
every 1.5 hours.
Whether or not those were forced by mom or asked for by
baby I don't know.
According to mom she offers the breast many more times per
day than 8-10.
Again, not sure if she is pushing baby to eat or if he is
asking. He
interpretation of his cues is interesting actually. She
takes his desire to
chew on clothing as a hunger cue - could be - who am I to
disagree? He is
teething so is chewing on his hands frequently and loves to
suck on his
fingers! Heck if I thought we could tape an SNS onto his
finger he could
darn near feed himself!  Mom is
desperate for this baby to eat more and
to take a bottle.
It will be very difficult to encourage this mom to stop
force feeding this
baby. I tried last night by stating several times
throughout the consult
that ALL feeds MUST be happy and relaxed. Her response
continued to be an
insistence to forcefully dropper feed to make sure he got
enough milk in. I
am not sure how to stop the force feeding without coming
off in a manner
that suggests to her that she is doing something really
wrong thereby
alienating her completely. She is so thoroughly convinced
her supply is
failing that I doubt I can convince her to simply watch the
baby and feed
when he asks.I need her to stay in contact, trust me and
talk to me.any
suggestions on how to word this would be appreciated.
Re: The scale - she is not obsessing on it. My reasons for
this were to
determine exactly what was going on with this supply and to
show her that
baby IS getting milk. She only has it for a week.
Provided she is charting
and weighing correctly (which we went over thoroughly) then
it will give me
and her some good information. I don't think this will
cause her any grief
- she was pleased to see that her breasts are not
completely empty as she
thought they were.
Re: Fenugreek. She is taking 4 tsp of the seeds soaked in
water (as per her
culture) per day. She smells like maple! Is this an
appropriate dosage??
I am much more familiar with the capsules or liquid
tinctures and told her
so. Input on that would be helpful as well.
I think that is it - to those who have posted publicly and
privately THANK
YOU! You are really helping me piece this all together and
giving me other
things to look for.
Warmly,
Jaye
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