Jody writes:
Bubble palates can change, but hers did not. We made sure she had a
weekly weight check to be sure she was gaining.
~~~
Agreed. Some babies whose palate has remained high/arched due to in utero
tongue restriction, will broaden and flatten to normal after the release,
and with ongoing feeding at breast, bodywork as needed etc. This can take
time, and may be part of why many of the releases I see do not result in
immediate change in terms of latch, milk transfer, mom's comfort etc.
Other babies seem to have the high palate without a noticeable releasable
restriction. They may have a deep Type 4, which I find the hardest
assessment to make. The baby I saw yesterday, who was 4 ounces over birthweight at 7
weeks of age, had a high palate. High palates are "midline issues", and
may occur in a constellation that includes tongue restriction,
laryngomalacia, increased reflux issues etc. Baby had no releasable tissue I could
palpate or see, though it may be hiding way back. Baby did have significant
laryngomalacia which affected breastfeeding and feeding with an assistive
device. Work of breathing seemed so high she would just sit and stare after
eating, her color was good but she looked so out of energy. Considering her work
load and her inability to feed adequately, she actually looked good
developmentally. Strategies to conserve energy, feed with support keeping in mind
baby's capabilities and needs, and an explanation of what was happening
seemed to help this mom and grandmom a lot. Apparently no one had explained
or noted the severe noises, fatigue, sternal retraction, etc that was so
obvious to the family. I have no doubt that a lot of skin-to-skin had been
really helpful in keeping this baby on track developmentally and mom was happy
to hear that. Sometimes I would actually like to see a TT I can talk
about, but some of these little ones have something like this which we cannot
fix so "easily".
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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