Elisheva
This is in response to your post of 1/25.  I recently saw a mother who had
her fourth daughter and was experiencing the very irritated nipples as a
result of the babies dysfunctional suck,  She reported that babies 2,and 3
had done same thing with very unpleasant BF experiences.  Baby # 1 had not
done this but had been 4 weeks premature mother had pumped then successfully
transitioned to breast.  This had always been her reference point and could
not understand why these term babies had problems.  My assessment was at
least for this baby that she had been a very tight OP( occiput posterior)
and had delivered that way.  Mother was very narrow and you could see by
this baby's position that she probably tucked that tongue to her palate and
then sucked the tongue when it was not tight in the palate. The baby's
preferred position was to keep the neck and head a bit hyperextended.  When
discussing this with the mother she thinks now that this was the exact cause
of the BF difficulties with the other two.  No 1 was much smaller and it was
not a problem. . After initiating a pumping schedule I called for the OT who
is seeing referrals from the LC as needed.  She used a "training "pacifier
that she could slip her pinkie finger into and then used it to accomplish
suck training.  To get the tongue off of the palate she slipped a gloved
finger along the sides of the tongue until she felt a small void and the
tongue released with a smart snap (!) The baby was put into cross cradle
 mother could let the baby stay a bit extended that way  and after three
attempts the baby latched.  The mother was so happy .  You could see "latch
" on the mother's face.  The OT had an intern with her that day who got to
see the potential of her work . A lot was accomplished  .  the mother and
baby were followed by phone and had one out pt visit and reported at six
weeks that nursing was going well and baby was on "auto pilot".  It is so
helpful to have a colleague sometime to help .
Beadie Cambardella LCCE IBCLC
Atlanta, GA ( Host to  the Super Bowl this year )

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