breast feeding advice (long)

[simsarch]

From: "simsarch" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Subject: breast feeding advice Date: Monday, 7 January 2002 8:49 AM   Like Jackie, I was the sister/auntie/midwife when my sister birthed her second baby in the same Birthing Centre in November.  What a great experience it was for me, really inspiring and a great encouragement to my midwifery practice.  A beautiful normal birth without unnecessary intervention and so empowering not only for my sister, but also for me as a midwife.  I felt truly blessed that I was able to share such a wonderful experience with my sister and her partner. Unfortunately baby Nick was born with a cystic hygroma which was a complete surprise to us all, and it is now that I write to this list to seek any advice regarding his breastfeeding.  His cystic hygroma is a fluid filled sac (500mls) around his neck which goes into his mouth and protrudes under his tongue.  Thankfully it is just a cosmetic problem which will be treated with surgery when he is around 6 months old. He cannot be operated on any earlier than this. He went straight to the breast at birth and appeared to suckle well and as my sister had a drug free labour he was lovely and alert, and for the first week of life it seemed as though breast feeding wouldn't present a problem.  However he is now 7 weeks old and is still only 50 grams above his birth weight of 4520g. He is now starting to look pretty skinny, but not obviously dehydrated, and still has lots of wet and dirty nappies, and is usually settled in between feeds (other than between the 5-10pm feeding frenzy time). He appears to attach and feed well @ every 2-3 hours at the breast and has had the advice of an independent L.C. who agrees with me on this.  My sister has been expressing and giving Nick a top up 4 times a day of 60mls of Ebm via a syringe (she cant manage a cup) yet his weight gain is no more than 10gs per day.  I think that the cyst is preventing Nick from getting a really good attachment, and other than expressing more frequently and topping him up (which I am sure she will find overwhelming as she has a very active 23 month old at home) can think of no other advice to give her.  The paed she is seeing, and is influenced by, is not breastfeeding aware and I feel is on the verge of telling her to supplement with formula. Can anyone offer any advice?  Kathy