Pam,
As Upledger Institute is in Florida, you would have a huge number of 
CST's there to choose from. I have worked with abbeis with the exact 
situation you describe--babies who have certain muscles so 
overdeveloped that others are almost not in use at all. This is exactly 
what CST treats so beautifully. One thing I did recently with a mom was 
combine regressive therapy with CST referral. Bbay was born breech at 
home after three hours of pushing and mom was transported to the 
hospital overnight--away from baby as hospital would not let him stay 
with her. He was so distraught when I saw him, he had only two 
states--shutting down and screaming, totally refusing the breast. I put 
mom and babe in the tub with warm water and the Bach Flower remedies (I 
think these are the ones) clematis, star of bethlehem, rock rose, 
aspen, elm, walnut and cerato and maybe gentian. Within 20 minutes, he 
came into his body and was ready to nurse. Dad was amazed by the change 
in him. He nursed shortly afterwards, but was also very tight 
structurally and had a tongue-tie. He is now 100% bf'ing--never had any 
AIM. I feel like your family would really benefit from such a combined 
effort. Babies will overdevelop the muscles they have control 
over--which may account for the observation that his tongue is fine--I 
bet it is not fine ("within range of normal" is not normal and frankly 
anyone who evaluates oral function without assuming bfing as the norm 
is not who this mom needs to see). http://www.upledger.com/home.htm (I 
have no affiliation with Upledger) .
Jennifer Tow, IBCLC, CT, USA




Date:    Wed, 26 Jul 2006 01:58:42 EDT
From:    Pamela Mazzella Di Bosco <[log in to unmask]>
Subject: weak lips and cheeks affecting latch?

Looking for input about helping a baby latch who has been 
unwilling/unable
since birth to take the breast.  When I first saw the couple, baby was 
only  4
days old and absolutely refused to even attempt to breastfeed.  This is 
 after
two days of non stop skin to skin, co sleeping included.  Mom is an
experienced breastfeeding mother of 4 previous children who took to 
breast
immediately at birth, nursed for years, etc.  This baby would not latch 
in  the
hospital
after normal vaginal delivery.  Mom began pumping and feeding  the baby 
with
a spoon and continued to do so for days.  Still no latching  baby.  
Finally,
mom frustrated and baby frustrated, mom used a bottle with  paced 
feeding, slow
flow nipple, etc.

This baby was so tense and tight  fisted and just screamed when placed 
even
in the proximity of the breast.   Even on the bottle the baby would not 
really
suck, more like a chewing chompy  motion.  Tongue would not relax, but 
no
tongue tie, and when not feeding  baby will put the tongue way out.  
Mom decides

to pump, bottle feed for a  bit and wait and continue to try to offer 
the
breast while protecting milk  supply and feeding her baby.  Two weeks, 
and the
baby
is just now relaxing  in her arms when in front of the breast, fists no
longer tight, arms and body no  longer so tense and stiff.  They come 
to see me
again, and honestly it was  like a new baby all calm and relaxed.  
Still, not
latching.  I have  seen a lot of babies over the years, but only a few 
who do
not
make the  connection between drawing in a nipple to suck even on a 
bottle.
This baby  used the tongue to try to force the bottle out also.

Okay, so what to do?  Outside my capablity.  I am totally aware  
something is
wrong, not a therapist for newborn sucking disorders, so cannot  figure 
out
what is up with this baby.  Ask mom to take the baby to the  
pediatrician to
rule out any reason to protect airway.  (Mom says when baby  spits up,
occasionally milk does come through the nose quite a bit, so at least  
she
should rule
out any possibility of a hidden cleft---not to mention I am  looking 
for a
good reason for this baby to not want to relax and eat.)   Next, to 
take the
baby
to a specialist (good luck in finding one that  understands 
breastfeeding).

Pediatrician says no reason for the  baby to be protecting air way.  
Okay,
one possibility not correct.  On  to the speech therapist specializing 
in
babies.  Her conclusion?  Baby  can suck, swallow and breathe just fine 
(of
course
only seen at the bottle,  since she did not ask to see how the baby 
reacted to
the breast, only wanted to  see how the baby bottle fed) and said the 
tongue
was within range of normal, but  the lips and cheek in relation to the 
tongue
were weak. Also, stated 'no  sign of sensitivity disorder'. was 
wrtitten (which
is at least one thing we can  rule out?)  Her diagnosis was that there 
is
nothing wrong, and the  baby just wants the bottle.  Told the mom to 
support the

cheeks during  feedings to help equalize the strength of the cheeks and 
the
tongue.  Those  were the exact words she wrote for the mom, and 
basically told
her that her baby  just doesn't want to suck except for reward, so the 
breast
does not offer  reward.  (Not making sense to me as the mom is a 
fountain of
milk and  easily expresses more than a full supply for this baby and 
can easily
hand  express milk into the baby's mouth, but baby still will not take 
the
breast.)

Quitting is not happening.  This is a mom who  breastfeeds in years not
months and she is determined to keep working until her  baby does 
breastfeed.
But,
since my brain always goes back to "A baby who  cannot breastfeed is a 
baby
with something wrong, because breastfeeding is the  biological normal 
behavior
to eat and survive", what is missing here?  I  have a plan in mind for 
mom to
try next since the therapist says there is  nothing wrong and baby 
should be
able to breastfeed, but am looking for other  ideas too.  And wondering 
if the
tongue and cheeks being week would make  the baby unwilling, unable to 
latch
to a breast as opposed to tolerating the  bottle (which in my 
uneducated
opinion the baby also does not appear to use the  way a baby typically 
sucks on
a
bottle.)  I do not think the bottle is the  culprit here because it was 
the last

thing used to make feedings easier and I  have worked with far too many
babies who have had weeks of bottles go to breast  easily once the 
bottle
feeding
method was changed and the option of  breastfeeding was offered 
properly.  This
baby does not suck the way a  breastfeeding baby should, and even 
though the
therapist says the baby is  'within range of normal' for behavior, 
maybe that
range of normal is not based  on normal at all, but is based on the 
ability to
bottlefeed?  I may not  know what is wrong, but I am fairly certain 
when
something is not right.


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