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Wed, 23 Feb 2005 10:44:45 -0500 |
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There are several types of seizures that can cause baby to involuntarily
bite at the breast - tonic and tonic-clonic. Tonic seizures consist of
tightening of all muscles in the body simultaneously. Mom might do more
damage than good if she tries to pull baby off the breast during the
tonic phase of a tonic clonic seizure. If baby is well attached to the
breast and his tongue is over his lower two teeth, mom will just get
clamped by the upper teeth on her breast, and baby will bite his tongue
with his lower two teeth. The tonic phase of a tonic-clonic seizure is
very brief, but can do tremendous damage to the poor person's tongue.
It is probably safest if he has a seizure during breastfeeding to just
leave him in place until the tonic phase is over, and dislodge him
rapidly as soon as the tonic phase ends and the clonic (rapid
contraction-release of muscles phase) just begins. This way she might
have two puncture wounds on the breast, but will not likely have gashes
from pulling the teeth along the breast.
Any attempt to force the mouth open during a seizure can cause damage to
the teeth and mouth, and is no longer taught or recommended. One thing
mom might be able to do is stick her finger in the angle of the jaw
where there are no teeth as soon as she feels any stiffening, but her
finger might be injured. She can press right through the skin diagnally
back from the corner of the mouth, so she doesn't waste any time trying
to get inside the mouth. This could prevent the mouth from completely
closing before she can get her breast out. My concern is that she could
lose her grip before the nipple is completely out of the danger zone,
and wind up with worse damage than if she had stayed put.
Another option is to have him re-evaluated by a comprehensive epilepsy
center with a pediatric division, to make sure he is on the most
effective treatment possible. Some of the newer drugs (particularly
topiramate and lamotrigine) are proving to be more effective than the
old standbys.
It would be useful to know if the seizures are generalized (occurring
throughout the whole brain at once) or secondarily generalized (starting
in one area and spreading). There are generally no warning signs for
generalized seizures (except the baby might be cranky or out of sorts
for a day or two before a seizure) but there are generally warning signs
and sensations for a secondarily generalized seizure. Your suggestion to
look for subtle warning signs is a good one.
Another good thing for mom to know is that if the baby has not had a
seizure while bf in 10 mos, despite frequent seizures, it is unlikely
that he will. Seizures tend to be somewhat stereotyped as to
situation. I know one child who had one during soccer games, every
single time he played. He was ultimately cured by surgery-removal of
one half of one hippocampus which had scar tissue from an in-utero stroke.
Hope some of this helps.
Catherine Watson Genna, IBCLC NYC
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