Trisha's question inspired me to ask my own. (I have permission to post.)

I saw a 4-week-old baby whose mom complained of nipple pain. Mom's nipples
were constantly pinched in all positions. Baby had grown well in the first
few weeks. When I saw him, parents said he fed up to every 1.5 hours during
the daytime. In the feeding I observed/assisted with, he transferred 1.9 at
breast.

Most notable about this baby was long periods of heavy breathing while
feeding - "recovery" breathing in breaks between working to suck/swallow.
He exhibited stridor both at rest and while feeding. His frequent feedings
seem appropriate to compensate for this difficulty, although I don't know
if mom will want to keep it up long-term.

The baby did have a tongue tie, but it was much more mild than most tongue
ties that I see. On the Hazelbaker ATLFF, his score indicated that
frenotomy is only necessary if management fails. He also had a type 3 lip
tie and couldn't flange his upper lip at breast.

** My question is: With airway instability like this, and the need for baby
to protect his airway, could he be intentionally pinching the nipple to
limit the flow - NOT pinching it as a result of his tongue tie? **

I looked in Supporting Sucking Skills and other places but couldn't find
the answer.

Thanks!
April

--

"There isn't anyone you couldn't love once you've heard their story."
- Mary Lou Kownacki

April Rosenblum, IBCLC

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