greetings,
after reading lots of relevant and interesting posts in the archives, i
would love some additional input into the following situation:
second baby, i know the mom well, previous breast reduction (12 + years
ago) which did not seem to impact first baby (now 3 1/2 yrs) and doesn't
seem to be impacting this one (10 weeks). baby is gaining great 7-10
ounces per week! nipples are comfortable, after a little soreness in
beginning that resolved with latch adjustments. baby has been very gassy
since birth, which also resolved somewhat with latch adjustments to reduce
air swallowing, and with some dietary modifications, but still requires mom
to get up at night and feed baby on the couch with pillows, etc., to reduce
air intake and then baby requires 20 minutes of burping to settle back
down. mom's main concern is that, although she has never felt that the
baby was latching perfectly (and i agree, having seen the nursing couple at
3-4 weeks pp as well), now feels things have gotten even worse, with baby
clicking at the breast off and on at almost every feed, and never really
opening mouth widely. gassiness from air gulping is main problem right
now, but i wonder how this basically chomping, gumming, not-really-latching
baby will affect moms nipples once teeth are in, and i also can't quite
believe the weight gain, based on what i saw, and worry about maintaining
such good weight gain with poor latch and suck. what i observed today was:
bottom and top lips tightly curled under, and top lip at least, very
difficult to unfurl (seemed tight). smallish, shortish tongue, with a
slight groove and white line at tip when extended (but it does extend over
bottom lip - i didn't get to see wether it lifts to roof of mouth or
not). no discernable lingual frenulum - in other words you can't see it
externally. i thought i remembered someone (barbara wilson clay?) speak
about a tongue that can be "tethered" internally, without an obvious tongue
tie?) baby also seems to lift *one* side of the tongue in a sort of
horizontal lopsided wave (never the other side). i could not get baby to
suck on my finger, although mom reports sometimes baby does suck well on a
finger. palate had a definite concave "bubble-like" indentation behind the
upper gum ridge, and baby had a very sensitive gag reflex, seeming to gag
whenever i got past the bubble shape much at all with my finger. also,
baby retracted tongue when i offered my finger. at breast, baby would not
open widely for latch, and once latched, really never achieved the wide
gape and rythmic jaw excursions. lots of clicking and "gumming" or more
like "lipping". mom reports baby *sometimes* achieves a better suck,
swallow, breathe pattern, and sometimes latch is even worse, and then it
does hurt. this baby passes meconium very quickly after birth, and then
didn't have a bm for 4-5 days! from then on, he consistently goes 3-5 days
between bms, but since he is gaining well, nobody sees this as a problem.
perhaps it is a clue to the puzzle? or a red herring .. . .
the mom nursed first child to 3 years, this baby was born at home, and
never has had an artificial teat.
we briefly discussed cranial sacral work, the dancer hand position, tongue
excercises . .. i am somewhat at a loss as to what exactly is going on
here, and how this mom can address it. she realizes it could be a lot
worse - with weight gain issues or painful nipples - but she would like to
nurse lying down at night, and for her baby to be able to more easily fall
asleep at breast. she would also like to address any underlying issues
that might result in problems later on.
hopefully someone here on lactnet (or many someones) will have a clearer
idea than i do about what might be going on with this baby. i apologize
for the length of this post, but the details seemed relevant. thank you in
advance for any insights you can provide!
going out on a limb by signing:
Lyla Wolfenstein
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
