Oops Sorry Nikki asked the question about pacifiers, and Trish the one
about the used pump!
In case it's interesting, here is part of an email I wrote to a mom who
doesn't call me, but always emails. I prefer talking on the phone for its give
and take possibilities, but she just won't do it, so this is how I
responded to her question about pacifiers for her baby. Baby is post-frenotomy.
"
The part of your email that makes me cautious about introducing a pacifier
is the part where you mention she still doesn't open her mouth wide enough
and sometimes has trouble controlling milk flow and gags. Though her tongue
is freer the bony shape of her palate is still changing over the next
months. If she is still gagging sometimes it may be because her palate still
needs to broaden and flatten and this takes time. Introducing a pacifier may
delay the change ( which in the end can have an impact on future breathing
and sleep issues) or it can promote the palate staying higher and more
arched. Breasts are larger and broader in the babies mouth so they actually
help reshape the palate. The other problem with all pacifiers is their length,
they tend to just end at the base of the pacifier itself, which means that
Noemia's tongue is not encouraged to extend as fully as when she is
breastfeeding, since the breast doesn't just end in a hard shelf. See if this
picture helps:
(http://www.google.com/imgres?imgurl=http://www.babble.com/CS/blogs/strollerderby/2009/03/pacifiers.jpg&imgrefurl=http://www.babble.com/CS/blogs/stroll
erderby/archive/2009/02/28/the-paci-debate-continues.aspx&h=433&w=337&sz=22&
tbnid=NiWWaf3m5Te5nM:&tbnh=126&tbnw=98&prev=/images?q=pacifier+pictures&hl=e
n&usg=__zVPsvtjKWWdSuulyxLBIAuRzNNw=&ei=UgUUS_fBKcejlAfontmRBA&sa=X&oi=image
_result&resnum=5&ct=image&ved=0CBgQ9QEwBA) The bulbous shape can make the
tongue shape weirdly around itself, this is exactly how you do NOT want
your nipple to look when she's done feeding, it hurts and it's an efficient
latch and a poor way to control flow. We don't want to encourage this at
all. Pacifiers that are not preshaped like this are better. Straighter is
better.
(http://astore.amazon.com/soothie-pacifier-20/images/B000W1M2EY) This is
a better shape in terms of not leading to the smushing training of her
tongue, since it is straighter and then broadens gently. Still the other
problem persists. The baby's tongue can but up against the base of the pacifier,
leading to the tongue being held back during nursings, which means poorer
latch, and less control of milk flow. If you were going to introduce a
pacifier, this would be preferable in terms of lowering the risk of it
interfering with her latching and coordination of swallowing. The other thing to
consider is that if she does not have painful reflux, she can get her needs
met by simply being at breast, where there is no risk of delaying palate
reshaping and messing with tongue function. Babies who are bottlefed often need
a pacifier because the total nature of feeding and calming has been broken
into the transfer of unchanging liquid/food without the milk changing at
breast as it does normally during breastfeeding. Babies who are bottlefed
therefore often cannot meet their sucking needs on the bottle without
overfeeding, whereas the breast is designed to meet every need ( at this age, I
mean.) If Noemia's need to suck begins to outstrip her need for food, she may
find her own finger/thumb, she can suck on yours or Tony's or you could
try the green Soothie kind of pacifier above and see if it doesn't mess with
her feeding skill development. The other thing to consider is some
CranioSacral Bodywork to help her release the tissues that are keeping her from
opening her mouth wider and controlling her tongue better. If this is
something you want to pursue, I can recommend someone who works with lots of babies
with issues around feeding, especially after frenulum releases ( I may
have mentioned this before, if I did, I don't mean to beat a dead horse, I
just didn't write in my notes whether I did or not.)
In the end, pacifiers are not without risk ( as I mentioned above, plus
they are related to ear infections), but for some babies who cannot soothe
themselves while nursing they can be helpful if used carefully. Nursing to
sleep can help a lot since we have evidence that nursing and sleeping in
proximity lowers the risk of SIDS, and though pacifiers are recommended as well
that is only if they stay in the baby's mouth the entire sleep episode,
otherwise you are getting up repeatedly to make sure they are back in since
the risk of SIDS increases in babies who go to sleep with a pacifier then
lose it during the sleeptime. When pacifiers are used in this way, they need
to be used for every sleep episode, daytime and nighttime. In some ways,
just letting the baby nurse is easier.
Isn't modern mothering a lot to deal with? :)"
END of my email response on this issue...
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
***********************************************
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
|