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Fri, 31 Dec 2004 14:14:07 -0500 |
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Remember it's not so much the palate shape that's problematic, but the
tongue movements (or lack thereof) that caused the palate shape. Babies
who were intubated have the shape of the tube pressed into their palates
for some time afterward. If they have sufficient muscle tone, they are
generally able to breastfeed with some time and patience.
Now that Zachary is off the vent, it can be very helpful to give him a
pacifier to suck while he is being gavage fed. This will help couple
sucking with feeling satiated, and give his tongue some exercise. Once
he can maintain his O2 sats during non-nutritive sucking, he can be put
to the freshly pumped breast during gavage feeds, so that he gets to
learn how to suck without the challenge of integrating swallowing and
breathing, which a baby who needs high flow oxygen is generally not yet
up to. Even having some skin to skin care against mom's breasts can be
a good first start with a baby this little, and this can have positive
developmental consequences too.
When he's up to just-pumped breast, a little skin to skin to stabilize
him first is a good idea, then position him at breast and hold him there
without trying to make him do anything. Just being moved is sometimes
enough of a challenge for very early little guys. Smelling a drop of
milk expressed onto the nipple is a good next step, and licking or
nuzzling the nipple may be his first step toward breastfeeding.
Maintaining a very generous supply is likely to be the best insurance
that he will someday learn to breastfeed. Bravo to his Mommy.
Catherine Watson Genna, IBCLC NYC
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