Trisha writes:
As baby nursed, she seemed to be "calmly" protecting her airway. No other
signs of distress like brow furrowing, gulping, color change, etc. She
would suck once or twice, swallow, and rest. Repeated this the whole feeding
even with compression. Oral assessment notes a fairly tight labial
frenulum, and possibly a posterior tie, but not nearly the worst I've seen.
Follow up yesterday (11 days since last visit -- obviously, I wanted to
see her earlier...). Baby gained 11 oz. in 11 days (same scale), but only 2
oz. in the last 4 days (doctor's scale to my scale -- possibly accounts for
difference in scale or is baby slowing in gain
~~~ I agree that there needs to be suspicion when comparing doctor scales
to ours. They can be accurate but they can also be way off, depending on
the scale and office. A difference of 2 oz in 4 days vs 3-4 oz in 4 days
could reflect only scale difference since we are talking about small numbers.
It's true that tongue and lip restrictions can cause milk control issues,
which could lead to pausing a lot, but they can also lead to milk transfer
issues which can also look like a lot of pausing: swallows are not being
triggered because not much milk is being transferred. Baby is resting due to
lack of input to continue. ( Baby could suck in a nice rhythm on finger
as well, not getting any milk to form a bolus and trigger a different
swallowing pattern>?) I would think a few good observations,or even one to start,
in which you can see if that swallowing pattern goes with moving 0.1- 0.5
oz after time, or moving an ounce 1/2 or two, or somewhere in between
would be very helpful to know.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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