Riva,
If the baby had a TT and LT, she should have had CST without question. It needs to be part of the routine care of all babies post-surgery. Fortunately, as we are increasing the numbers of dentists doing laser revision of ties, we are finding a stronger base of support among the surgeons for bodywork. In fact, Dr Kotlow has just revised his patient hand-out instructing all mothers to follow up with their IBCLC and that the baby is to have bodywork post-revision. 


Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC



Date:    Thu, 4 Oct 2012 23:06:22 -0400
From:    "Catherine Watson Genna BS, IBCLC" <[log in to unmask]>
Subject: Re: persistently sleepy baby

Congenital hypothyroidism? Does the baby have a somewhat large tongue 
also? The two can be associated. If the baby is hypothyroid, treatment 
is important to preserve cognitive capacity and health.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

On 9/11/2012 2:42 PM, Riva Weissfish wrote:
> Good afternoon to you All,
> I apologize in advance for this long post – I couldn't find a way to make it 
shorter.  TIA for your indulgence.
> I have a situation that has me stumped and I am not sure if it because it is 
truly unusual or my expectations are mistaken.
> I saw baby R and her mother the day they were released from the hospital at 
about 60 hours of age. She was born vaginally with an epidural. Birth was not 
unusually long, no extended pushing and no other interventions besides the 
epidural. Baby was not placed directly on Mom but did "breastfeed"  a few 
minutes after the birth.  By day 2 in the morning she "was not latching" and had 
been given a supplement at night. Otherwise she was trying (unsuccessfully) to 
breastfeed.  We worked on waking her up," Biological" positioning,  other 
positions, and paced bottle feeding.   I identified a tongue tie, left them with 
a pumping plan(which is working out great) , trials of breastfeeding and 
supplementing with her own milk every three hours – since baby was absolutely 
not waking for meals.  She also was doing STS and some suck training. . Had TT  
and ULF revision the next day.  I saw them again 4 days later. Baby had not once 
woken to eat on her own and still had not latched. Her weight gain was good so I 
suggested giving her ( R) a day to determine when she needed meals  - hoping 
that now that she had enough calories, sts and was a bit older she surely would 
set her own schedule.  I suggested they not let her go over 5-6  hours more than 
once.   She still did not wake up and did not compensate by eating more at each 
meal and took four meals of 80 cc that day.
> She is now 11 days old we have gone back to waking her for meals about 8 times 
day and will only wake on her own  for meals twice a day (in the middle of the 
night and about 6 hours later) I had them switch  to an SNS for both nursing and 
finger feeds but Mom reports that she will not latch for her (I did get her to 
latch when I was there)  but does nicely with the finger feeds, though it takes 
longer than a bottle but she can at least get her to suck, making a vacuum to 
suck in the milk, but always in her sleep. Overstimuation/ avoidance? They tried 
putting her in a less stimulating environment (quiet, darkened room) to no 
avail. They returned to  STS with Mom, Dad and Grandma. Pediatrician is not 
concerned about the sleepiness, checked baby and doesn't  identify any problem. 
I felt that by now she should wake for meals as well as eat with open eyes. Her 
color is good, she is plump and healthy looking and her muscle tone is also good 
(when you try to wake her she gets good and mad!)
> The only thing I could think to suggest at this point is CST, but since I 
haven't a clue what the problem is how do I know if CST is the right direction?  
The family is amazing, sticking with it, trying to get baby to latch throughout 
the day. Could it be she is hooked on the finger feeding? We tried a silicon 
nipple to give her a more similar feeling to the finger /bottle but she simple 
doesn't open her mouth. She is  ASLEEP!  She cries and gets angry when 
stimulated and as soon as she snuggles into her mother she falls back asleep.  I 
keep thinking that she will wake and be more alert with the time but do not want 
to miss something important going on here.
> Any suggestions? Am I missing something?
> Thanking you for your patience if you read this far you must be very devoted 
and patient –waiting for your insight
> Riva Weissfish BA,CCE,IBCLC
>







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