Pam writes,

"Mom has 4 month old baby, exclusively breastfeeding, in 50th percentile.
However, mom has had recurrent mastitis and plugged ducts. "

Despite mom saying she doesn't have OMER, mastitis and recurrent plugs often
accompany overactive MER since breast is never fully emptied.  If I remember
correctly  from Cathy Genna, around 4 mos sucking becomes volitional and a baby
who can't handle flow (perhaps also with this baby weak tongue muscles/oral
structure) begins to do things he wasn't doing before to compensate and because
now he can.

With history of tongue tie, this baby may have needed tongue strengthening
exercises that he may have done naturally if on bare breast and latched well.
So many times, moms aren't taught to use the shield correctly and baby just
nipple feeds, using suction more than compression.

Since tongue tie is a midline defect, other problems may accompany it, low
facial tone, upper body low tone, etc.  An occupational or speech therapist with
NDT (neurodevelopmental training) who works with infants, especially feeding
issues, would likey be helpful.  Upright positioning of baby, or prone might
also help bring tongue forward and help baby handle flow which may/may not be
normal.

Barbara Latterner, BSN, RN, IBCLC








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