Bottle feeding also shapes the palate, especially in the baby born 
early, whose palate is less mineralized and therefore more 'plastic' or 
malleable. So a baby born early who had mostly bottles 'would' have a 
narrower palate.

Also, there's the IUGR. Some kids with IUGR have genetic disorders that 
caused them to grow more slowly. These can be subtle, tiny deletions. 
With a genetic disorder, the slow growth often persists. If there's a 
genetic syndrome, the palate may look very abnormal (the usual medical 
meaning of a high arched palate rather than the LC definition, which is 
subtler). Genetic syndromes may cause hypotonia, which causes weak 
tongue movements, which shape the palate poorly. Take a look next time 
you see the baby.

  If the baby was growth restricted due to decreased blood flow (mom 
with hypertension or a condition that impacted the placenta's growth) 
they will catch up once born, and skills will improve along with nutrition.

NOW, for the mom's pain - if her milk production is very low, the baby 
will use a higher vacuum during sucking, and more effort during 
swallowing. This could cause the sore nipples. Using a nursing 
supplementer of some sort for moms with very low supplies can help by 
providing more flow so the baby exerts less pressure, and the mom's 
nipples are more comfortable. If adding more flow doesn't change the 
pain, then something mechanical is wrong, look again at the latch and 
sucking.


Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 2/14/2011 9:22 AM, Tania Archbold wrote:
> Hi lacnetters,
>
> I have mother's permission to post.
>
> I have a question about bubble palates.  I know they usually come along with
> tongue ties, but I have one case which that does't seem to be the issue.  I have
> seen a fair number of type III and IV tongue ties, so I don't usually miss
> them.  Baby is 9 weeks old, was induced at 36w5d due to slow growth in utero. 
> Baby was born at 4lbs 8oz.
>
> Baby was mostly bottle fed from birth, mostly formula, some EBM.  Mother
> contacted when baby was 9 weeks old wanting to transition baby back to breast. 
> Baby is currently 8lbs 12oz
>
> Baby is willing to latch, but doesn't open mouth very wide. Upon digital exam
> palate appears to be high arched.  I think it is probably a bubble palate from
> the way it feels.
>
> Mother has gone from bf 4 times in 24 hours to 12 times in 24 hours upon my
> encouragement to increase her milk supply.  Baby is also receiving some formula
> as suppliment as well as some EBM while her supply increases.
>
> Mother has very sore (but not cracked yet) nipples.  I have suggested ways of
> improving latch, using EBM on nipples, and lanisoh cream.  I have passed on info
> about coconut oil, but haven't brought up the MediHoney yet since I am not sure
> if it is available around here.
>
> Any other suggestions for nipple soreness with a bubble palate?  Will the latch
> improve as baby grows?
>
> I have also showed her some tongue exercises to get baby to use her tongue
> properly, but I don't think parents have tried them yet.
>
> Baby is very laid back, does't have a worried look, but does get frustrated at
> the breast (which is understandable after bottle feeding for her whole life).
>
> Tania IBCLC
> www.mothersnectar.ca
>
>
>
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