Erika,
 
Is it possible this baby has a submucosal soft palate cleft?  This  comes 
to mind with the issue of milk out the nose.  It has been found that  very 
often babies with anterior tongue ties have another component of posterior  
tie.  The use of nipple shield may provide baby with more inner oral  
stability so wouldn't be in a hurry to wean from shield at this time.   Maybe baby's 
slurpiness with bottle is due to lack of usual tongue mobility but  could 
also be a tone issue.  I've seen an increasing number of babies with  motor 
tone issues in addition to tongue-tie.  I don't quite know what you  mean by 
a proactive doc but if this physician will do a basic neuro exam of baby  
and refer to early intervention this may be a good course of action (mom can  
also contact early intervention on her own, doesn't need a referral).   
Addressing the posterior TT will obviously also be important and pointing out to 
 this doc that cleft of the soft palate needs to be ruled out.
Barbara Latterner, BSN, RN, IBCLC
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
 
I have a client with a 9 week old baby. Baby was tongue tied and was  
clipped
before mom came and saw me...about 10 days old.   However,  the baby was
still not latching after clipped.  I noticed that the baby  was using
positive pressure or tongue thrusting. I instructed mom to get a  finger
feeder and help retrain baby to suck correctly. I just revisited this  baby
who has poor milk transfer at the breast. Mom is using a shield.   Baby
throws a fit if brought to the breast without it. Mom has  wonderful
elongated nipples but still the baby is resistant to latch without  shield.
Baby is not tongue thrusting but has a weak suck for a 9 week old.  Mom has
been pumping after every 40 minute feed at the breast and then offers  the
baby 3 ounces of milk via a bottle. Baby shows consistently loud slurping  
at
the bottle and arches backwards when the milk flows. I readjusted baby  and
bottle with paced feedings and baby still slurpy but not so  stressed.
Parents report baby chokes on occasion if medication or fluid gets  shot 
back
in mouth.  Parents report that baby is stuffy all the time and  that baby
gets milk up the nose. This baby has slow weight gain and I noticed  an
obvious submusosal tongue tie.  I am sending this baby to a really  
proactive
doctor to rule out any other health issues as my gut is telling me  that
something is not right.  I feel really bad for sending this family  back for
more oral surgery but what are the options at this point? Can a baby  have
other reasons for the symptoms presented?   Just needing some  reassurance.
Thanks.

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

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