I agree with Laurie Wheeler's suggestion to have a neurological consult
for this baby. Babies with neurological conditions can have very
uncoordinated tongue movements. Mostly the tongue lifts and drops, with
a pumping/pistoning movement. Sometimes the baby does not respond to
normal stimuli at all. If it's a neuro issue, gentle massage and
stroking around and inside the baby's mouth can help draw the brain's
attention to the tongue, and help the baby improve her tongue movements.
There are several published strategies to do this, most have in common
stroking the cheeks from tmj to corner of mouth, stroking the lips to
encourage rooting, rubbing the outside of the gums from front to back
repeatedly (3 times in each quadrant so the baby can anticipate the
movement and start to follow with the tongue), and then stroking the
inside of the cheeks and then the tongue. Midline stroking from tongue
tip back to mid tongue is most likely to stimulate sucking movements,
and then there's the old "walking back on the tongue" exercise, which is
meant to simulate the direction of muscle activation during sucking.
I'd also feel under the baby's tongue. Sometimes this constellation
(very little tongue mobility with a tongue that does not look tied)
occurs with a submucosal tongue tie, other movements seem normal (baby
roots) but the tongue can barely move, except for asymmetrical lifting
movements at the corners, one corner at a time. If there is a submucusal
tie, you will feel a tight string in midline below the center of the
tongue, instead of the resilient genioglossus muscle at the base of the
tongue.
It can be snipped in the office, but bleeds a little more, because the
fold of the floor of the mouth that must be snipped a little to get to
the frenulum is vascular. I'm going to talk about our research with
these sneakier tongue ties (submucosal and posterior) at ILCA. (Can I
say this?, we don't get paid to present at ILCA.)
If it's a neuro issue, encourage mom to feed the baby her milk however
the baby can take it, and continue offering the breast at least a few
times a day. Tincture of time is amazing, one baby with a neuro issue in
my practice first latched at 5+ mos, and was breastfeeding exclusively a
week or two later.
Catherine Watson Genna, IBCLC NYC
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]
|