Dear wise ones,
I have a lovely couplet that I have been trying to help for over 3 months
now and would love to have some feedback especially from those in private
practice who work with older babies.  (I am a hospital based LC).  First
time mother of a full term healthy baby born via c/s.  C/S was for failure
to progress which means nothing here with over a 40% initial c/s rate but
that is a story for another day.  Baby spent the first 3 days of life skin
to skin and working w 2 experienced IBCLC's.  From the get go baby did not
know how to latch.  She simply clenched her jaw and chomped, if anything.
There was no visible tie, but we suspected a submucosal one.  Mother went
home pumping and had frenulum cauterized by plastic surgeon. Mother did ot
return for follow up with lactation until 2 weeks of age.  Fortunately, her
milk supply has been and continues to be excellent. It was noted then that
baby chomped on bottle as well.  Suck training was tried and, at our
suggestion, she followed up w a speech therapist who felt the oral
structures and suck were normal.
Fast forward to last week when baby started to latch.  Mother had not even
tried for several weeks when baby just started rooting on own.
Unfortunately, the latch is not good and mothers nipples have become too
painful to latch her.  Baby can stick out her tongue, palate seems slightly
high but not very high. Mothers question to me is: can baby learn a correct
latch at this age?  I question if the tongue might need revision, but
mother doesn't want this. I appreciate any insights into this case.
Mary Westra RN, IBCLC

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