I saw a nice mom and baby yesterday for a consult, she is trying to
breastfeed a baby with a trisomy 9, not sure of all this entails with this
particular infant. Diagnosis was profound deafness but he is making all
sorts of sounds. He is almost two months old, has never latched properly.
He is a bit hypertonic, clenches his mouth.  She is using the Avent bottle
but has opened the hole up because it took him an hour to feed and he was
not eating well.  His intake is only about 17 ounces a day, combined breast
milk and formula, mom's milk supply is low, not pumping enough. We talked
about this and she will try and build supply.  I gave her some homework, to
try and get his mouth open and lips flanged with the Avent, lots of skin to
skin, bathing with baby, checking to see if she can find a cranial sacral
therapist. After watching him briefly at the breast, decided that latch at
that moment wasn't going anywhere, child was hungry and frustrated, whipping
head back and forth with mouth mostly closed. I could not get him to drop
his jaw with my finger on his chin.  Tongue is down, suck seems strong
enough to me.  Infant is strong enough to roll front to back.
I will only be in town till Friday pm but back August 1st and will revisit
then.

Pat


Pat Thomas PHN IBCLC
Winona County Community Health
Winona, MN

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