Hi All

Need some wisdom!  Went to see a mommy today (permission to post) with a 2wk old girl.  This mom is very experienced; 3rd baby, toddler 2+yrs also nursing.  She is a LLLleader, had a wonderful home birth, no separation, baby went to breast right away, lots of skin to skin.  

Ideal situation, right?  Arggg......!  Baby is a good size and is gaining like gangbusters, mouth is "smallish" - she is a newborn but this is just her anatomy... mouth is kind of "dainty".  Mom's nipples are big with pretty stretchy, elastic skin.  I've seen lots smaller babies handle much lgr nipples but they are all individuals.....  So here is the issue: baby opens pretty well to latch and mom has getting her on down to a science but when the fairly strong letdown comes baby manages with coordinated suck/swallow/breathe for a few minutes then pushes the nipple forward in her mouth, almost up under her top lip.  Baby has great tongue mobility; tongue is almost long, quite wiggly/mobile, good cupping clearly seen at breast but while sucking on a finger her tongue was retracted behind gums and humped in back.  I know that a finger is not a nipple and she was sucking without flow at the time but I wonder about what could be going on with that tongue?  Is she pushing the nipple up and out to cope with strong flow? difficulty with bolus control so protecting her airway?  tongue muscle fatigue from keeping it down and forward? There has to be a reason for this - babies don't just do this. 

I know we are looking at function not form but form is just seems soooo good that I want to know if the tongue isn't restricted - and though there is no visible frenulum, the mucosa/mouth floor could certainly be hiding something! - why is she using it this way?  Mom is very sore, bruising and blanching.  Baby led/self-attachment is painful too.  Is planning to see an experienced Chiro soon, mentioned CST to her, she is open.  We talked about ways to reduce flow so baby is not overwhelmed, keeping feeds efficient so baby is not fatigued and mom is not to sore.  There is no comfort feeding going on here!  Baby seems to do well for the first few minutes of the letdown then does the strangest trick with her tongue and jaw to get the nipple pushed forward and then won't relatch "properly".  She will go to the other breast and latch well there but then does the same trick again.  Latch is not a real tight seal either, kind of loose and leaky.  No strong vacuum; living on let down situation.  Sat and thought and watched for a long time, talked about getting baby to play some games to keep tongue down and out, accept something deep in her mouth.  Very alert, organized, bright baby - my initial thoughts were everything from "grow her quick, get lots of practice, keep trying/teaching her" to submucosal/posterior TT to submucosal cleft of the soft palate.  Midwives are stumped, doula too and she is 25+yrs LLL.  What am I missing!!??

Thanks for any insight, mom is very keen to hear what you all might have to say!

beth IBCLC 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome