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Date: | Wed, 6 Apr 2005 00:38:42 -0400 |
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I find this the hardest situation to deal with - the baby who slips down
the nipple deliberately and chews mom up. It often happens in infants
with slightly tight tongues, high palates, and strong gag reflex. If
mom can hang in for a few months, relatching whenever it gets too bad,
the pain resolves, but it can be very difficult. A few things that have
worked in the past for clients with this issue:
Using a mini haberman feeder and when baby can tolerate this, switch to
the regular (longer teat) Haberman for "relief" feedings until baby can
tolerate the feeder well in the back of the mouth.
Fingerfeeding to work on tongue movements, again as relief feedings,
with whatever finger movements stimulate the best tongue grooving and
peristalsis. Sometimes this is pressure from the nail side of the
finger against the posterior tongue as it humps up, sometimes it's a
gentle tiny amplitude circular massage on the anterior tongue to keep it
over the gum ridge.
Breaking the latch and reattaching the baby every time he or she slid down.
Encouraging mom to pump and alternate feed a few times a day as needed
until the baby stops "killing" her, wide based bottles can be helpful
for improving gape during alternate feedings and patterning a more open
mouth posture during sucking (evenflow comfi wide; gerber comfort latch;
playtex natural latch). Avent's teat is too long and firm for this
purpose, IMHO.
Using prone positioning and keeping firm pressure on the baby's shoulder
blades.
None of these approaches is perfect, but they can help over time.
Catherine Watson Genna, IBCLC NYC
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