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Mon, 21 Nov 2011 07:23:40 -0500 |
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Dear Jessica and listmates,
I would try a nipple shield to see if the infant is able to better use
the tongue. I am beginning to think that many of the sucking dysfunctions I
am seeing are caused by limited/decreased tongue function and mobility due
to the trickier and more subtle Types II-IV, not the easy to spot Type I TT.
I think a baby who cannot maintain a deep latch, even when the mother is
assisted by the LC, or who repeatedly leaves the nipple compressed or new
lipstick tube-shaped, has a TT. I am finding that this is happening even with
a mom with great nipple/areola anatomy. This is so hard for the parents to
comprehend. I do give them the info from Dr. Kotlow. It is hard enough to
get the pediatricians around here to think that this is important and make a
referral for an evaluation or release of Type I. I don't have much hope
that they will begin to realize there is a reason for a baby's struggles with
breastfeeding when the problem is not too visible.
Let us know how this case progresses.
Mary-Jane Sackett, RN, IBCLC
Pittsfield, MA
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