Hi All, Wow did I get a doozy today. Baby is 20 days old and just now back to exactly birth weight. Mom saw a different LC on day 9 who found a baby at a 10% weight loss, got baby feeding (mostly bottle as baby still could not latch well on a nipple shield and would not latch without) and mom pumping to stabilize her supply. (You are on this list – thank you! You helped her a lot by protecting her milk supply and baby!) Mom chose to see me as I am more local to her (10 minutes from her house!). I have her permission to post. So – a lot of stuff here. Baby born at 38 wks weighed in at 7’ 1”. Baby was frank breech, born by C-sec and Dr’s discovered umbilical cord wrapped twice around baby’s neck. Baby had a cone head at birth. Baby never was able to latch at all – hosp nurses gave a nipple shield telling her it would be the only way baby could get her colostrum. Baby is now completely unable to latch w/o it – but is unable to latch deeply and well. Baby has NO soft spot on back of head – cranial bones visibly overlap in such a way that is obvious to even the untrained eye on all sides of head. Also the top of baby’s head is ever so slightly tilted over to the left and the back of the head has a noticeable bump (one of the cranial bones) and looks like ½ of a ball stuck to the back of the head. Jaw appears ever so slightly recessed – looks like he had a baby overbite...and the right side of his jaw is a tad bit higher than the left. Obviously there are some real issues here – appropriate referrals for treatment have been made. Now for the really crazy stuff. Baby has what might be a posterior tongue tie – but I could not see anything notable about tongue movements with a visual exam – no nothing, no real appearance of tongue stuck to the floor of the mouth – but he wouldn’t stick his tongue out to the bottom lip. Put baby to breast – he sucks the breast as if it is a bottle. He does not do any compression to speak of. Initially he appears confused as if he doesn’t quite know that to do with this thing he just opened his mouth for (he does this on the bottle too). Finally, after fussing about a bit, he ‘gets it’ and starts sucking. NOT suckling – but sucking – little cheeks sucking in – looks like he is trying to suck a straw even when we were able to change the latch and get him on a bit deeper. He is able to get small amounts of milk out with a LOT of effort. He also has LOTS of penetration of milk and I believe some aspiration – this kid got so noisy I gently asked mom to take him off the breast as I was very concerned. Once I saw what he was doing I did a suck eval. OMG! I have never felt anything like this at all. There is very little peristaltic wave – baby clearly cannot and does not elevate his tongue to do compressions – is that the possible tongue tie? I am not sure yet. His suck swallow breathe pattern is bad, leading to penetration and possible aspiration. As long as I kept the milk flow slow he did not have any penetration – however he tried to do the normal compressions for maybe 3 sucks, but then he quit and started using suction only – all sucking – no compressions. It was the weirdest feeling. The other thing that was weird – it felt like this little boy had no soft palate – it was all hard! Where the soft palate should be nice and soft and spongy – it was instead, firm and felt bony and kinda bumpy like the hard palate. I had my finger so far in this boy’s mouth I was surprised. He let me gently feel as far as I could feel – no gag reflex, perfectly happy. But also a hard soft palate. I told mom I’d have to ask about this one as I have never felt anything like this. Now – my question is: What the heck is this? I see this baby having several issues: Possible posterior tongue tie, obvious physical issues, obvious suck swallow breath issues and a palate (soft) that makes no sense to me at all. So – I have referred them to treatment for the body issues. I figure once the body issues are corrected we can re-evaluate the possible posterior T-T. If that is an issue, get it clipped. I am hoping that the body issues are the cause of the SSB issues and that those will resolve with correction of the body. If not, we refer to a specialist for that too – no problem. Some of this he may grow out of – he seems to be a ‘young’ baby at 20 days even tho he was born at 38 wks…he still ‘feel’ to me to be premie. But what about this palate? So, Wise ones – what am I missing – what is it I don’t know that I need to? Thanks for ALL input! Warmly, Jaye *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]