Could be the frenulum is almost non existant (tongue not lifting far enough,
causing baby to have to use too much neg. pressure to compensate.) However
you describe tongue tip up in front. Sometimes babies do that to defend
airways against intrusion. I wonder if finger feeding is best way to feed
such an orally defensive baby. I'd opt for shield instead as it allows baby
more control. Just make sure you are using newborn small size and really
stretch it when applying to make sure it's on tight and not moving around
rubbing on already sore nipple. I like newborn small size and use almost
exclusively because there is less teat space for baby to have to suck up and
fill with mom's nipple. you can stretch the base to fit over almost any
size nipple. Tx for thrush a good idea even if just prophylactic. Tell her
to boil shield too. Check the labial frenum. If it is super tight it may
be causing upper lip to curl in. This could be clipped by pedodontist if
nec. See old issue of JHL for article about this (I don't have ref. but bet
KAG knows details). Time and growth will improve situation. Getting baby
positioned so that chin is really jammed into breast and nose backed away
will angle the tongue as close to breast as possible.
Barbara
At 10:26 PM 10/29/97 -0500, you wrote:
>>Date: Wed, 29 Oct 1997 22:25:25 -0500
>>To: LACTNET
>>From: Kathleen Bruce <[log in to unmask]>
>>Subject: help please: short tongue
>>Bcc: kga, jack
>>
>>Hi.I am working with a mother and need feedback, please. Mother is older
>first time mom. Very very intelligent. Reads voraciously. An attorney.
>Father is ill, and dealing with pain, and so this is causing additional
>stress. Mom calls me from hospital, needing bf assistance. This is 10 days
>ago. I have seen her 3 times since. Things were good for a while. Baby
>was not latching at all at first visit.. I have seen her three times since
>then. Baby would not latch at all on day 5. Baby would latch and suck well
>with silicone nipple shield. Milk supply good, supported with double pump,
>and baby was being finger fed with syringe in addition to feeding on shield.
>Mother very relieved to have any breastfeeding happening at all. Over next
>few days, mother was able to discard shield for 50=75% of feedings, but now
>is SORE as all get out. a "7" on a scale of 1- 10. I took a good look
>tonight again.
>>
>>Baby is growing well. Tongue is SHORT. When baby cries, tongue goes
>straight to roof of mouth. Doesn't extend much farther than lower lip, which
>is small. Slightly receding chin. Big suck blister on upper lip. Hard for me
>to even flange lips when bf. Positioning good as far as I can tell, although
>it would be nice if lips were flanged more. Clutch hold seems to help.
>Mother able to bf comfortably for a few seconds in that position tonight,
>but feels that she must use shield, because of the pain. Baby's output is
>good. Just keeps bobbing on and off the breast, and will finally settle into
>sucking for a few minutes, after a long battle.
>>
>>As mother changed baby, I saw a red yeasty looking rash. Mother put some
>Ivory soap on washcloth, when washing bottom, so it could also be that..but
>it looked suspiciously like yeast to me. I have her all my info on that, as
>well as my BF tomes/books..and she is going to read this. SHe is coping with
>an ill husband, and incredibly sore bf , and is going to give it a few more
>weeks, and then will consider bottlefeeding breastmilk. Palate is normal.
>Suck feels normal to me. Frenulum is not even visible under tongue. I just
>see a wall of tissue, and a tongue that seems short.
>>
>>Sigh.
>>
>>ANy insight would be appreciated. Thanks. Kathleen PS I am not so much
>worried about the shield, as baby is getting enough, and mom's supply is
>good. I am worried about the pain. I am thinking that if tongue is short,
>that baby will grow into breastfeeding. Mom's breasts are fairly large, with
>smallish nipples. Pink. I just can't figure out what else to do , except to
>trouble shoot for thrush as well ( gave her gentian violet in water, .5%,
>info, Jack.).
>>
>>Thoughts? PLEASE?
>>
>>Kathleen
>>
>Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
>http://together.net/~kbruce/kbbhome.html
>LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
>LACTNET WWW http://www.telcomplus.net/~kga/lactation.html
>
>
>
Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html
|
