To Melody Engberg

As an OTR/LC in two different NICU's, I think it important to make the
distinction between disorganized and uncoordinated suck. What are the lips,
jaw, and cheeks like in terms of muscle tone and range of motion?  Did the OT
who saw the baby do a developmental assessment? Most pediatricians have less
training in developmental assessments than they do in lactation, so I would
not take the peds word that the baby is developmentally o.k. Is the OT
trained in infant swallowing disorders? What is this baby's respiratory
system like? Has the baby had a video swallow study to rule out things like
delayed swallow, pooling in the valecula, etc. A pediatric occupational or
speech therapist in an acute care hospital may give you more insight into
further tests. The whooshing sound when she swallows may indicate that the
baby is not only demonstrating signs of oral apraxia but also poor swallowing
control. Does she choke at all? Spit up at all?  Have solids been introduced
yet? Can the baby sit up in a high chair yet? This baby should definately be
followed closely by an OT/PT/Speech Therapist with neuro training and
swallowing training, at least until 12 months. Feel free to e-mail me direct
if you want more suggestions.

Debbie Rabin, OTR, CLC
Los Angeles, CA