I did search the archives and found one interesting post about this, but am
wondering what to do to best help a mom and infant.
I went out yesterday to see a mom who had assured me she could make it
through the weekend, I should not have taken her word for this, but had a
full schedule on Friday. She had trouble initially, has largish nipples, one
larger than the other.  They gave her breast shells at the hospital and sent
her home with infant feeding only on the left side and sore nipples.
I got there yesterday to find her in tears and an infant who would not
latch, pulling back and fussing.  She had been pumping and feeding him
expressed milk, had six borrowed pumps in the living room.
We worked with latch but the infant was pretty frustrated, would start and
pull back, the milk was rolling out of the nipple, mom has a great supply,
can pump six ounces.  I don't think that the issue was too much milk for the
infant to handle, he wasn't on that long.
We finally fed him with the bottle she had been using, trying to work on
some lip flanging and mouth opening skills with him.  When we took the
bottle out of his mouth, the shape of his mouth was pretty interesting.  He
clearly had his tongue rolled and his lips folded in.
When I looked at his mouth, the palate looked and felt okay, his tongue had
an odd look to it, almost notched but no frenulum problem and he can extend
it out fine, but when resting in his mouth, it notches visually.
I reassured her that we would work on it and will be going back out several
times, but am wondering how best to proceed.  The post I did find in the
archives suggested that he may have some neurological difficulties.
I feel like I am in a bit over my head on this one.

Pat Thomas PHN IBCLC
Winona County Community Health
Winona, MN

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