**Baby: Gaining weight normally, happy, no more crying. No tight
frenulum (under tongue or to either lip). Palate feels normal, no high arch or
bubble. Lots of audible swallowing throughout feeding. And no distress
noted during times of milk ejection reflexes. The only thing that I saw that
might be problematic is how “wiggly" baby is at the breast**
When I see a baby who is seemingly uncomfortable while breastfeeding, legs
moving or being drawn up, I think about digestive issues, from something as
simple as needing to burp, to allergy/sensitivity to something mom is
eating which has caused irritation along the GI tract, to baby's difficulty
swallowing due to abnormal tongue movement as in posterior tongue-tie (reflux
included with tongue-tie and/or food sensitivity).
I recently observed one 3.5 mos old who needed a second tongue-tie
revision due to inadequate first time clipping who went from constant motion at
the breast to calm, longer feeds. This brought up a discussion in my group
where two other babies were unsettled at breast; one could be mom's diet
which she's investigating with a nutritionist, and the other likely due to
lowered supply which is being worked on.
All moms were unaware of normal infant calm when at breast and the one with
the frenulum issue expressed relief and joy that now breastfeeding was
pleasurable for both baby and herself and that she found baby now
breastfeeding to sleep and for comfort. The other two are eager to reach that same
experience.
Based on my observation of babies of any age, newborn included, the baby
who pummels the breast, pulls back, is off and on frequently with frantic
hand movement is experiencing difficulty handling normal flow and swallowing
which most often is due to tongue restriction. (The older baby who grasps
mom's breast or plays with her bra strap is just doing normal hand
exploration, the rest of his body remains relaxed). This is a simplified
explanation, but the main point is that, as you saw and have questioned, a baby who is
wiggly at breast, whether it occurs from top or bottom, is uncomfortable
and teasing out why is important. I wonder why this mom continues to have
nipple damage if breastfeeding/ infant suck is not problematic? Some of our
cases involve lengthy investigation and a ruling out of possible issues,
and I suggest you keep exploring and follow your instincts that something
still isn't quite right. Please let us know the outcome.
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
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