PTP - working with a mom and one month old baby.  History -- readmit to another hospital at 4 days due to dehydration, fever two days later, bacterial infection, antibiotics, PICC line, blood clot from PICC, 2 1/2 week hospital stay, Lovenox for 6 weeks.  Feeding "well" in the hospital per mom, but started nipple shield for poor latch.  Weighted feeding 1 1/2 weeks ago showed 30 mL transfer, but mom felt supply was dipping in the last week.  Mom called for a visit with me on Friday.  Weight gain was poor, AC/PC transfer showed 2 mL and 6 mL.  I feel pretty confident with assessing for posterior tongue tie... we are referring to our laser provider ALL THE TIME.  Dr. Kotlow's technique of sweeping under his tongue did NOT show a "speed bump."  Surprisingly, I think this kiddo has the smoothest submucosal layer I have felt in a long time.  Pressing both fingers under his tongue to expose the frenulum did NOT expose a tight, white band.  Extension and lift are great.  Lateralization is great.  I did not do the rest of the Hazelbaker assessment because I feel I need more practice with that system.  But his suck assessment and function was crummy just like a PTT.  Lip tie noted, but not the worst I've seen.  Mom's homework was suck training and protecting her supply.  Today, four days later... great weight gain, mom has a nice milk supply, but function and transfer (8 mL as mom supplemented at breast, and 0 mL with other breast as supplemented at breast) is the same as before.  My assessment was the same.  Doesn't "look" or "feel" like PTT, but it sure "acts" like one.  Mom has the milk... baby is just not transferring.  I have suggested bodywork and chiro... unfortunately, we do not have an actual CST around us.  Mom's homework is more suck training and supplementing at the breast and continued protection of milk supply.  Speech therapy consult and encouragement to see our laser dentist will come at the next visit if no improvement.  Wise ones... what am I missing?

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome