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
[log in to unmask]

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome