Jennifer

I will preface this by saying I am not really familiar w/ CST other than 
what I have read on lactnet and on internet and I approach clients more from 
a 'medical model' I guess.

Your description would have me thinking craniosyntosis (sp?) as the head 
would not still be molded,  and neuro symptoms and possibly a syndrome; he 
may have a recessed or receding chin (pierre robin sequence???).  I would 
probably refer to the primary doc (assume pediatrician) for a neuro eval or 
to genetics and probably to an OT specializing in infant fdg if I could find 
one. I like the NOMAS (neonatal oral motor assessment scale) reference re 
feeding as dysfunctional vs disorganized and this sounds dysfunctional.  I 
would of course have the mother be very careful to protect her supply and 
feed with the easiest method for the baby, keeping in mind as much bf 
behaviors and bottle nipple characteristics as I could. I would think her 
pain was from the dysfunctional suck / tongue tie and not thrush and 
possibly the mom could benefit from ibuprofen regularly for a while and / or 
something for nerve pain. This would be in archives.

<<What he does with this bottle is very odd--his mouth is very wide (his 
head is much narrower toward the top--the birth was very rapid)-- and he 
used to move his jaw side-to-side rather than in
excursion. He no longer moves side-to-side after the CST, but his jaw still 
has little mobility. He pulls his cheeks inward close to his mouth to hold 
the bottle nipple in his mouth, as his tongue does not cup the nipple. Even 
with the clipping, his tongue is short and remains flat, his palate is high, 
but broad. >>

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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