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Lactation Information and Discussion <[log in to unmask]>
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Mon, 2 Jul 2007 08:00:20 EDT
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Just want to clarify something about Susan's and Kristi's recent posts re 
feeding tube placement which describe tubing placement as going "under" the 
tongue.  

Susan , do you not mean that the tubing is taped wherever baby's tongue will 
be with latch, but the breast, along with tubing, goes over the tongue?  So if 
baby is positioned in cradle or cross cradle, the tubing is taped to inner 
aspect of breast, and if positioned in clutch hold, tubing is taped to outer 
aspect of breast; if baby coming from under the breast in a side sitting or 
modified clutch hold, then tubing is taped to underside of breast.  So tubing 
follows baby's tongue placement rather than the illustrated SNS version of tubing 
placement on upper aspect of breast with tubing tip pointing toward floor, 
which puts the tubing closer to the palate or corner of baby's mouth.

Maybe it's just me, but when I visualize something being under the tongue, I 
see it between the tongue and floor of the mouth, which is not what is meant, 
I don't believe.  Please correct me if I'm wrong about this and if my 
explanation is off.  I don't mean to be picky about this but wonder if others might be 
a bit confused about the semantics of wording, "under the tongue."

"if the tube is taped to the breast so that it will be directly
 under the tongue."

"I like the idea of placing it under the tongue."

And I thoroughly agree about nipple shield size; had a recent client pull out 
a 16mm shield she'd been given in hospital and I couldn't figure out why, so 
now I know that people were trying to match nipple size.  I find, too often, 
that moms are not taught how to mostly turn shields inside out and apply, also, 
nor given written instructions or consent to use.  Medela has instructions 
for use of shield on their site and Diane Weissinger has a lovely handout for 
shield use, both of which I give moms to keep and refer to, as well as an 
alternative equipment consent form which mom signs and goes in her report.  
Application of a shield makes a world of difference.

Barbara Latterner, BSN, RN, IBCLC


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