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Thread: Really slow nurser - is there anything that can be done?

  1. #1

    Default Really slow nurser - is there anything that can be done?

    I'm nursing my 3 month old adopted son with a medela sns. I'm pregnant as well and am expecting in about 5 weeks so I should be able to drop the sns at that point. My problem is that nursing is soooo slow. He'll take 1 hour to 1.5 hours per nursing session (fwiw I'm using the large tubes). He's a little faster with a bottle with a slow flow nipple but still quite slow (~45 mins). I've been afraid to introduce a faster nipple for fear that he would give up on nursing. In general he seems happy and sleeps well, sometimes maybe a little too well.

    I'm pretty sure that his latch is fine. He's the fourth baby I've nursed and I took him to the closest thing to a lactation consultant in my town just give me a sanity check.

    He's quite small for his age (3rd precentile) but he may just be a small person. He's also a little delayed on some of his milestones and he may have some effects from alcohol or drug abuse during the pregnancy. He was also a foreseps delivery so there might be some damage from that. We've run a bunch of blood tests on him but that hasn't provided any clues. My dh is a GP so he's under a doctors eye.

    I'm concerned that when I attempt to drop the sns and nurse the regular way he's just going to fail.

    Do you have any suggestions for what I can do to encourage him to be a little stronger and nurse a little faster?

  2. #2
    Join Date
    May 2006
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    21,355

    Default Re: Really slow nurser - is there anything that can be done?

    I don't know there's anything you can do now. I mean, once your milk comes in again, you'll know to look for diaper output and all that, and that will give you a good idea of whether or not his nursing efficiency is what it should be. Other than that... I think you just need to wait? 3 month old babies often aren't really fast nursers yet.

    How does nursing feel? Everything okay on that front?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Jun 2009
    Posts
    5,911

    Default Re: Really slow nurser - is there anything that can be done?

    How much (how many ounces) is baby being fed each feeding?

    If it were just slow feedings with the sns, I would suggest maybe try a different at the breast supplementer. But since bottles are also slow, and I do think 45 minutes is quite slow for a 3 month old (?) I wonder if there is something going on with baby's suck patterns or ability to suckle? I am afraid that sucking issues are well beyond my ability to advise on, but you may find some useful information here: http://cwgenna.com/smartnothard.html and http://cwgenna.com/biomechtechniques.html

    Aside from the long sessions, are you concerned at all that baby is not getting enough to eat now?

    I'm concerned that when I attempt to drop the sns and nurse the regular way he's just going to fail.
    so you will be tandem nursing this baby with your newborn? assuming good enough milk production and milk ejection, I would think it is most likely baby would have an easier time extracting milk right from the breasts, especially if you are able to nurse both babies at once. But of course this is all a bit unknowable, and it's hard to know at this point how nursing will initially go with new baby, which will be a factor. But if this baby required more than he can get on his own, could baby continue to be nursed at the breast and supplemented with bottle and/or sns as needed?

    Have you ever tried cup feeding?

  4. #4
    Join Date
    Mar 2014
    Location
    Central FL
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    1,502

    Default Re: Really slow nurser - is there anything that can be done?

    Are there any occupational therapists or speech pathologists in your town experienced with working with infants and suck/swallow disorders? They could probably help with some stretching/exercises that might help if this baby has some weakness or disorganized suck.

  5. #5

    Default Re: Really slow nurser - is there anything that can be done?

    In response to some questions:

    Nursing is comfortable. Besides how long it's taking and his weight issues everything seems fine.

    There is definitely not a therapist in our town experienced in these issues. We live in rural northern BC! I can look into what's available within a couple hours of us but I'm not that hopeful.

    Maybe there's a suck/swallow disorder but I can't preceive that. I would guess he just weak. Some of the milestones that he's behind on are strength related, like head support. The lag isn't dramatic but it's definitely there. Are there issues that could be there that would be unnoticable to the mother?

    I've also tried a lact-aid but because medela's sns offers different tubing sizes I've had more success with it. The first link that lllmeg provided had a suggestion of a feeding tube attached to a syringe. I gave that a try this afternoon and we definitely improved our feeding time.

    I'm somewhat concerned that he's not taking as much as he would if nursing was easier. He usually seems full when he's done (sated face) but sometime I get the feeling that he's just tired of nursing.

    I'd like to tandem feed when the next baby is born but I don't know how well that will work. I've always had to support my breast with my hand in order to keep my nipple from falling out of my babies' mouthes. I just don't know how to one hand nurse. I'll give it a try but I'm not very optimistic. I'm going to try to continue to nurse him at the breast but if it's taking 1+ hours at a time I don't know if I'll be able to keep it up. I have 5 other children! If I don't have enough milk or if he just can't draw it from my breast the sns should allow me to keep it up but if it's still taking so long I just don't know how I'll be able to manage.

    Thanks for all your suggestions. I'd like to do what I can to be able to keep nursing and to help this little one in whatever way I can. Nursing has been so good for our bonding. I wonder if this long nursing has been all God's way of helping us have ample bonding time. I can see the silver lining to this cloud but I still need to work it out. Thanks again.

  6. #6
    Join Date
    Jun 2009
    Posts
    5,911

    Default Re: Really slow nurser - is there anything that can be done?

    Some IBCLCs will use Skype for appointments.

    I think you have to assume there is SOME intake issue. I hate using "shoulds" as of course there are always exceptions. But, IMO, it really *should* not take so long for a child this age to eat. It indicates something is up.

    If this were me, I would contact Catherine Watson Genna in NYC and ask if there were any way she could help or if she had any suggestions of someone who might. Why her? Because she literally wrote the book on supporting sucking skills in breastfed infants, and I guess one of her suggestions helped you already. I would also suggest contacting Jack Newman's Breastfeeding Clinic (they are in Canada at least) and see if THEY have any ideas for getting you help. You have a unique and interesting situation, and you are doing something so incredible and loving by nursing your adoptive child while pregnant, it just seems to me the universe should be helping you here.

  7. #7

    Default Re: Really slow nurser - is there anything that can be done?

    Ahhh, thanks.

    I agree with you that something is up. I think that I will see who I can find to help. I was also thinking of buying the book that you mentioned. Do you think that it could be helpful? I can't believe how much more he's been willing to take now that I've switched to the syringe. It makes me feel a little sad that I didn't just give him a bigger nipple on a bottle. I'm sure that the colostrum that he's getting compensates for what he's been missing out on though.

    I just noticed that you had asked earlier how much he was taking in in a feed. Here's what his normal day looked like: 120ml (4oz), 150ml (5oz), 150ml, 180ml (6oz), 120-150ml. I'm not scheduling him down to 5 per day. He basically trained himself to sleep through the night. When he was waking in the night he would only take about 60ml (2oz). Today though he's taken 150ml, 180ml and 240ml (8oz)! He's never taken 240 before. I hope we can turn a bend here.

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