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Sat, 9 Jun 2007 08:59:16 -0400 |
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Look under that tongue. The tongue shapes the palate, if the palate is
high, narrow or otherwise unusually shaped, it is probably the fault of
altered tongue mobility.
A subset of infants with altered tongue function use excessive pressure
during sucking as a compensation. Sounds like this baby is one of them.
Donna Geddes (formerly Ramsay) stated at the CLCWA conference 2 weeks
ago that 10 infants using excessive negative pressure in her study
reduced their sucking pressures when using a nipple shield.
I usually try fixing the latch first, to see if allowing the baby more
autonomy (and more time to get the tongue in position) allows a deeper
more comfortable latch. If that doesn't work, look at the tongue and see
if there is a tongue tie, and if so, if mom can access treatment (some
of the subtle partial tongue ties can be easily missed, and many docs
are hesitant to treat them). If mom can't access help, she can try a
nipple shield.
Catherine Watson Genna, IBCLC NYC
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