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From:
The Jones Family <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 17 Oct 1998 19:51:10 -0600
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I only had a couple replies to my last inquiry about bubble and high
palates.  I seem to be seeing a rash of them.

How common are high arched and bubble palates?  Is there anyone in a
hospital-based practice who examines every baby's mouth and can give me
some idea about the frequency with which they occur and how frequently
they cause breastfeeding problems?  What are the confounding factors
that increase likelihood of problems.

Thanks to the person who quoted the article in a midwifery journal about
compressing the breast with more pressure underneath than on top to
direct the nipple toward the back of the baby's mouth.  I have tried it
a couple times.  The trouble is that I infrequently see the results of
what I have done and don't know if the advice helped or not.

Just saw a nursing dyad at about a week postpartum.  Mom had scabs over
the entire face of both nipples.  Her concern was that the baby was
getting blood and that the scabs might come off in the baby's mouth.
Although she winced with latch, she never complained about her own pain.

Latch looked great.  No problem with tongue mobility.  Only thing I
could see was a high arched palate.  When I explained to mom what I
thought the problem was, she said, "Oh, I have a high palate."

I suggested finger feeding every other feeding for suck training and to
help mom's nipples heal.  I sent her for a hospital grade electric
pump.  I asked her to call back the next day, but haven't heard from
her.

It is mom's like this that keep me going.  What devotion!

A few days later I say another mom whose baby was only 3 days old.  High
(bubble?) palate and slightly short frenulum.  Mom's nipples scabbed
over entire face.  Taught mom to compress breast as above and corrected
a somewhat poor latch, suggested nipple shells.  We discussed the short
frenulum, although it will take major proof that it is interfering with
breastfeeding before the peds will consider referring her to ENT to have
it clippled.  For now, I had her compress the breast as described above
and relatch baby as needed (heard occasional clicking).  I told her that
she might have to continue holding the breast and holding the baby in
position so she doesn't come off the breast.

I have been reading Wolf and Glass, but I'm not finding much to help on
this issue.  What are the rest of you finding?  How do you deal with the
situation.  I want to give mothers honest appraisals, but I don't want
to discourage them.

TIA
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA where the cooler is no longer on all the time

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