Hi All,

I am preparing a presentation both for our LC and maternity staff on the 
NOMAS (Neonatal Oral Motor Assessment Scale) tool. Does anyone have 
experience with the validity aspect of this scale in the first few days 
after birth. I spoke with Marjorie Meyer Palmer, the developer of the tool 
and she stated that it is 100% reliable in the neonatal period, but did not 
give me a clear answer on the first few days of life.

The scale evaluates both jaw and tongue action in neonates and rates sucking 
as normal, disorganized or dysfunctional. We all see babies who cannot get 
it together in the hospital and it may range from drugged babies, prolonged 
pushing, may I say epidurals!!!!, meconium at birth or excessive mucous the 
first day or missed feeding cues due to separation of mother and baby.  And 
this is leaving maternal anatomy out of the equation as NOMAS evaluates only 
the feeder not the "vessel".

She states that 50% of babies that are rated by a skilled NOMAS certified 
evaluator to be disorganized with sucking and 100% of babies that are 
dysfunctonal with sucking are found to be developmentally delayed by 36 
months of age.

This is quite concerning because according to her protocol, quite a few 
babies that I see in the newborn period are clearly not just disorganized, 
but show distinct dysfunctional sucking patterns.
I am not fully certified in evaluating babies by the NOMAS , but have been 
working with babies at the breast for 17 years now and sure see more and 
more babies with an inability to breastfeed well. She did comment that I was 
not the first LC to bring this to her attention and that perhaps epidurals 
play a part!

Anyone know of specific research using this tool during the first 2 weeks of 
life in a newborn setting (not NICU) and following these babies for the 
duration related to developmental outcomes?
So many times these moms end up pumping and bottling, or not breastfeeding 
at all so we lose contact. This would be an interesting research project 
IMHO.

LuAnn Smith RN, BSN, IBCLC
York, Pa
On a perfect late spring almost summer day!

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

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html