Hi everyone - I need help!

 

I've had a run of toughies and I am looking for some ideas, input -
whatever!  I have full permission from all moms to post: Here we go:

 

Case 1.  (case 2 and 3 in the next post)

 

Baby 8 wks old.  Very fast delivery.  No meds, no forceps or vacuum.  BF
great first 12 hours then suddenly refused to BF for 12 hours - would scream
at breast.  LC in hosp (who I know and is good) assisted and helped baby to
get back on.  But mom felt something wasn't right. Baby has never been a
'great nurser' according to mom.  The first 4-5 wks she had constant pain
with nursing with L-O pain starting at 5-6 and settling to 2-3.  At 3 wks of
age he started "freaking" at breast - even when he was hungry (I just
thought about overactive let-down which I will ask mom about today) - he
would root, lick and gum the breast "violently" until he would finally after
several minutes - latch.  At age 2 wks mom reported a horrible smell coming
from babies mouth.  Ped thought that behavior and smell might be related to
reflux so started baby on Zantac - it has helped the smell and a tiny bit of
his behavior.  Mom also took dairy out of her diet per Ped to see if that
would help too.  She is not sure it has.  Mom reported baby's suck as always
weak - he would do better on the breast in the mornings when the breasts
were more full but toward the later part of the day (when the breasts were
softer and more flaccid) things would get worse and the angry behavior of
baby would progress to the point of nearly non-stop screaming leaving
everyone exhausted.

 

Baby is chronically fussy, unhappy, cranky.  He is NOT meeting developmental
milestones - refuses to interact with anyone for more than 1-2 seconds -
easily over stimulated.  Despite all this baby has managed to maintain an
entirely appropriate weight gain - but here is the catch:  He was gaining
approx 2 oz per day - then at 2-3 wks ago that dropped to 1 oz per day.
Under different circumstances I would not be alarmed - but with this I am
concerned.  Mom also reports her breasts are less full in the mornings now -
significant difference from last week to this week.  She has started pumping
2-3 times per day to protect the milk supply.  Baby has only been given a
supplementary bottle 1-2 times per week.

 

I did a suck evaluation and this baby's suck is one of the weakest I have
ever felt.  How he gets milk is beyond me - unless mom has a fabulous
let-down.He took 3 oz at breast however, there was a lot of suction breaking
and cheeks dimpling in.  His suck IS disorganized per finger feeding.
Tongue moves up and down, sometimes there is suction but most times I could
easily pull my finger out of his mouth.  He drops his tongue way down in the
back losing any suction he did have.  When he is on the breast there is a
lot of lip movement.  I have never seen anything quite like it.  Mom repots
that baby did have blisters on top and bottom lips for a couple weeks.they
thought that was a good thing.  

 

My thought with this one is that (ruling out over active MER which I will
look in to later) something is really not OK here.  Baby's body is out of
alignment so I am referring her to CST/Bowen to help with that.  My main
concerns are 1) baby NOT meeting behavioral milestones (this kid is not "IN"
his body) and this suck that will, eventually, cause him to not get the milk
and moms milk supply to drop even more than it has.  

 

Open to all thought and ideas.

 

Thanks! 

Jaye

 


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