In a message dated 97-10-15 02:19:11 EDT, you write:

>The baby appears to attatched well, but mums nipples are
>sore (at 10.00), and blanching and no matter what I do, it is not
>working.  She has tried all the positions.  Lately the baby feeds ok
>some nights, but the days are awful.  Nipples are graspable, baby has
>no oral, nasal or chin problems.  My latest theory is that baby the
>baby is tongue thrusting.

Val and Netters,
We need to be cautious when we use certain terminology.  The reason I am
saying this is because over 12 years ago I use to use the terms "clonic bite"
and "tongue thrusting" loosely.  I was told, nicely, by some physical
therapists/NDTs that I best understand what the term means before I diagnose
or label something.  In "Feeding and Swallowing Disorders in Infancy.
 Assessment and Management." by Lynn Wolf, MOT, OTR and Robin Glass, MS, OTR
they state "A tongue thrust, which implies a forceful outward component,
needs to be differentiated from simple tongue protrusion.  Observation of the
tongue at rest and during active sucking is necessary.  Tongue thrust during
active sucking is gererally associated with increased tone, particlularly
increased extensor tone and possibly CNS abnormality."  I was corrected that
clonic bite and tongue thrusting usually indicate neurological damage and to
use the terms for what I was seeing "tight jaw" and "tongue protrusion".
I am presently working as a LC, RN at Easter Seals here in the Chicago area
one day a month in a followup/feeding clinic with PT, OT, NDT and speech
pathologists.  It is wonderful and I am learning so much from them.  It was
interesting when we all got talking about finger-feeding and they asked me
how the LC field ever came up with the name finger-feeding.  Of course, I
turned alittle red and told them I had written an article back in 1987 to
show people how I had discovered a  new technique on feeding BF babies to
avoid using bottles and therefore nipple confusion. For lack of no better
word, I had labeled it finger-feeding.  They proceded to tell me that
finger-feeding in their field means actually placing cereal or food on their
finger and feeding the baby/child.  Once again, same terminology used for
different techniques.  I can see how things can get confusing, especially by
the parents.  By the way, I do feel that finger-feeding is very much misused
today, but I will just shut my mouth up for now. Have a good weekend
everyone.
"You cannot change circumstances or people.  If you don't like the way your
life looks, try changing the way you look at life."  by Lisa Engelhardt

Pat Bull,RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL