Robin Glass and Lynn Wolf indeed wrote a chapter in SSS, the one on flow
dynamics... They keep talking about revising their own book, but are
very busy with their hospital practice and their workshop.
Catherine Watson Genna BS, IBCLC NYC cwgenna.com
On 3/26/2012 9:57 AM, [log in to unmask] wrote:
> Cathy writes:
>
> I am not sure how therapists are being taught about neck position for
> infant feeding, but for children with cerebral palsy or other neurological
> issues eat solids, therapists are taught to tuck the chin a tiny bit (stabilize
> it back toward the neck, in a mostly neutral position). Perhaps that's the
> source of the confusion? Overapplying a special case?
> ~~~
> Hello Cathy and all,
>
> I think we're on to something here. The SLT I've been working with did
> exactly the opposite of what I had demonstrated to the parents: held baby
> tight, with pressure behind the neck to push it into a light flexion/neutral
> and she said it was "more stable." I think her underlying message was "during
> bottlefeeding, for a baby dealing with some other issue" - for instance
> she thought this baby was low tone. Babies that are having difficulty
> bottlefeeding for a period of time long enough to consult an SLT would generally
> mean that this baby is having some kind of issue. The babies we are usually
> helping to bottlfeed more safely may have state control issues, or other
> neuro issues from being early, or even from the current assaults of a "normal
> birth" around here. But they may not be permanent issues that are obvious
> enough and challenging enough to bring in an SLTor other Early Intervention
> specialist. In this situation, I contacted her because a formerly thriving
> baby ( but with a mother in misery) had precipitously seemed to lose the
> ability to get enough to eat at breast, or to sleep normally, and was
> faltering in weight. I think that because we are the one profession was actually
> understands deeply and thoroughly what physiologic and emotional normal is
> for human little ones, we look with different eyes. A baby who can
> bottlefeed well enough not to fall off growth curves pretty much gets passed
> over, no matter how many other, sometimes obvious, other times subtle, issues
> we see. Even though this baby was later evaluated and found to be of
> "normal tone" and not qualify for services, I have serious thoughts that in the
> future he will be back in EI for something that wasn't big enough to see
> now, but will become more obvious later. I feel like I see this more and more.
> Even though Wolf and Glass's book is '92 it still seems to be the standard
> for treatment, and again these babies are not "normal" babies who got off
> track and we might be able to help them get back on with our supports,
> information and temporary interventions. The titles may be very potent: Wolf
> and Glass's book is Feeding and Swallowing Disorders, Cathy's is Supporting
> Sucking Skills in Breastfeeding.... two different sets of eyes looking, and
> what they are looking for, two different views of what the outcome could
> be: safer bottlefeeding for children with disorders vs normal
> feeding/nurturing at breast with all the tied-in mothering that can go with it. It's not
> that SLTs are against breastfeeding, but their profession was born in a
> time when mostly no one was thinking of a baby breastfeeding as a normal
> developmental skill worth fighting for, whereas ours was born of the idea that
> breastfeeding (like bipedalism) is a normal developmental skill for humans
> which our bodies are well-adapted to complete ( unless something major is
> standing in the way) and therefore always thought of as the "default" goal.
> Although we live in a culture that still does not accept this, it is a part
> of our view of normal human skill acquisition, and bottlefeeding or other
> assistive feeding scenarios are what we settle for when the norm cannot be
> achieved. The fact that bottles are widely thought of as normal and
> necessary make our roles harder ( witness the new ads for American Reunion, where
> Alyson Hannigan's character indicates her motherhood status by holding a
> bottle in the photo.) Perhaps someday Wolf and Glass and Cathy Genna will
> co-write a book!
>
> One can dream...
> Peace,
> Judy
>
> Judy LeVan Fram, PT, IBCLC, LLLL
> Brooklyn, NY, USA
> [log in to unmask]
>
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