Dear Colleagues,
I have permission to ask for some input on this situation. I have to admit, 
I'm a little stumped.

13 week old has "clicked" from the start. Mom and I have been trying to hook 
up since baby was around 5-6 weeks old but with my recent schedule, it wasn't 
possible. Mom is a Family Practice Resident. Mom going back to work in a week, 
concerned about milk supply (sometimes gets 4-5 ounces and sometimes 1/2 
ounce depending on time of day.She is using a small personal double pump.)  

Finally saw baby today and here's what's going on. Mom has been laying baby 
on pillow (Brest Friend), using cross cradle to latch, was pulling breast back 
a little. We put her in football with regular pillows and baby didn't click 
for almost 15 minutes. As she fell asleep, she started to click (sliding down a 
little). When I did a suck evaluation, baby has some tongue thrusting,  and 
does not trough the tongue to suck. Palate of normal height, not excessively 
gaggy)  Mom states that baby has a "weak" suck sometimes and stronger others.   
Is concerned about different types of bottles and the way their use has 
"changed baby's suck." Baby has had several "treatments: by a doctor of osteopathic 
medicine. Mom is not interested in CST. Good weight gain, stooling every few 
days (HUGE amounts) good skin tone, happy otherwise.

I created a plan to increase milk supply (renting hospital grade pump) try 
Mothers Milk Plus, fixed the positioning, helped wit back to work questions but 
what to do about the clicking? 
Mary Kay Smith, RN, IBCLC
Canton MI USA

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