I wrote the last post at 5:00 am today - then went to work and had one of my
worst tongue-sucking days ever!  Was it a self-fulfilling prophesy?

Had a breastfeeding class, returned 10 telephone calls, worked on Inventory and
faced the following in-house:

#1 - Baby was latching on to tip of nipple and sucking loudly on tongue.  Heard
swallows (of air, not milk).  Used my usual positioning of baby at breast with
nose to nipple.  Latch on improved.  Mom learned about putting BREAST not just
nipple in mouth.

#2 - Baby opened wide, lunged at breast, then went on to "click" and suck then
drop off the breast.  Over and Over.  Tried all positions except Lactation
Consultant Hanging From Ceiling.  Suck check did not reveal any terrible tongue
movements, slight tongue thrust combined with moms very soft breast and nipple
was not a good match.    Mom was just "trying out" breastfeeding, and after this
decided this is too hard and wants to bottlefeed.

#3 - NICU baby who was discharged 5 days ago (and was breastfeeding well)  and
now back after bili was found to be 21 (at day 21 when baby is alert, stooling,
etc. Tests are being run for liver damage.)   Breast milk had been stopped,
bottles of formula given for 24 hours, then bottles of breast milk resumed and
now baby was to try breastfeeding again.  Tongue sucking continually - in her
sleep or awake.  Not interested in opening mouth or breastfeeding even though
mom's supply is wonderful and nipples firm and easy to grasp.  Time was of the
essence as had to be returned to phototherapy lamps.  Used Nipple Shield, baby
latched on wonderfully, heard beautiful gulps - will face weaning later....

#4 -  Another NICU baby.  Shaped tongue in a U and used it to swallow air almost
like a straw  - never seen anything like it!  Had to burp baby A LOT to get some
of the air she had swallowed out so she'd realize she's hungry.  Moms milk
supply good as she's been pumping, but nipples were very sore and bleeding.
Able to get baby latched on, but Mom in lots of pain, Tongue visible below
breast, still in the tight U.  Another Nipple shield.  Breastfed well, mom not
in pain.
Mom will be trying to feed without shield this evening as she is now not so
fearful of failure.  She stays nearby and comes in to nurse when NICU nurses
call her, so bottles will not be necessary.

#5 - 24 hours old, rooming-in, no bottles ever, sucking tongue and lower lip.
Used my positioning of baby on top, nose to nipple.  When attached, taught mom
to use thumb to pull out lower lip.  Baby nursing OK when I left...

On my trip home (1 1/2 hours gives you a lot of time to think), I wondered if
some of these problems MIGHT NOT have been caused by bottles or anesthesia, etc.
(I know this is heresy!) Could it be that many of the babies that used to die
was because they were so bad at breastfeeding that they starved themselves?  Am
I just in denial?

a very tired Jeanette Panchula, BSW, LLLL, IBCLC, RN
Puerto Rico -  Thank God Edouard missed us - will be wishing same for the
Mainland.
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