Subject: bottom lip sucking in while feeding

<<I have a mum , third child with some interesting problems. First 2 babies
breastfed with little problems., Baby is 12  weeks old.  Has had painful
feeds since birth.  Has had recurrent blocked ducts and what sounds like
classic white spots on right breast.  Suffers from upper quad engorgement
when white spot occurs that is partially resolved when white spot is>>

Dear Ruth
Ouch this hurts and it does make one wonder what else is going on with that
mother that she would allow this problem to go on for 12 weeks.  Not good
for baby and certainly not good for mother. That she has nursed two other
children with no difficulty gives her a reference point of what is a
successful breastfeeding experience.
Are you in a community with an OT that can address oral motor issues ?
Take a look http://www.beckmanoralmotor.com/.  this site might list
therapists in your area that might see this mother baby pair.
I am fortunate to work in a facility with a beckman trained OT and what a
difference that makes.  The OT is trained also to watch for other cues from
the baby's behavior and motor activity that might demonstrate other areas in
the system that might not be as developed as should be for a baby that age.
Her exam is very thorough and the parents learn a lot and learn some
exercises to do with the baby.
If a mother had a child that could not read by a certain age she would most
likely search out the best reading specialist in the area to help her child.
I just had an appointment with a dyad this week and she exhibited all of the
symptoms that you described in your post.  The baby was 16 days old (the
mother was on a round of antibiotics for the infectious mastitis) .
She was fatigued because the baby also tired before finishing so the baby
would snooze it was not getting enough in a reasonable period of time.  .
Mother was using a pump to protect milk supply and had rented a pump during
the bout of mastitis. It did not take me long to realize this was oral motor
dysfunction .This was first baby and mother had no reference to a successful
experience, but she knew it was not getting better.  ( By the way this
mother had a hypnobirthing  class prenatally and had a very uncomplicated
birth experience) (yea! there are still some pleasant birth experiences)
We called the Ped for a referral to the OT .  She consulted with them the
next day.
I am not a therapist but can recognize when one is needed and the problem
outside the scope of my practice.
I hope that you can find one for your family.  It is sometimes said in the
south "the baby is the barometer of the household"  I wonder what it has
been like for rest of that family for the past 12 weeks ?
Keep us posted.
Beadie Cambardella RN BSN LCCE IBCLC
Atlanta, GA

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