-- [ From: Beverly Solow * EMC.Ver #2.10P ] --

Hello all,

It's Memorial Day weekend and difficult to find local sources to confer
with.  I just received a call from very frustrated parents.  I've seen
this mother and baby three times during the past week.
#1 visit (5/20): Wave motion of tongue didn't start at tip of tongue
but the middle.  Baby (3 days old) didn't open wide and liked to suck
just on tip of my finger.  It was difficult to get finger well into
mouth.  When fingerfeeding, suck improved -- mouth wasn't so tight and
wave motion of tongue improved.  At breast baby opened slightly and
placed mouth on nipple but would not attach.  After some suck
retraining and fingerfeeding, baby latched on well and nursed
beautifully.
#2 visit (5/22):  mother asked me to come back because she had
difficulty getting baby to take right breast--no problem with left.
Again we got the baby to nurse well.  Suck felt much better--mouth not
tight.
#3 visit (5/27,one week after initial)  Baby refusing breast for a day
or so.  Mother has breast infection and is overproducing.  Possible
yeast -- tongue is quite white.  Mouth is tight--like one week prior--
but no difficulty fingerfeeding..  Baby became agitated very easily
when offered breast. Not opening wide.  After many tries, and
fingerfeeding her about an ounce of expressed milk so she was pretty
relaxed, we got her latched on.  She nursed beautifully as she is quite
capable of doing.  Mother's breast felt so much better.  While nursing
(and afterward) baby's breathing was noisy--sometimes sounding as if
vocal folds were not completely closed.  I asked if baby had ever
coughed and sputtered from forceful letdown--mother didn't think so.
5/28--The father just called me. The pediatrician found the breathing
to be unremarkable, but baby wasn't making the noises then.
Overproduction has improved.  However, baby isn't nursing.  She takes
breast for 5 seconds and then becomes agitated.

I'm stumped.  At second visit, I really felt like things were going
well, just some fine-tuning needed.  A few days later, things
deteriorated.  While I was still able to help the mother get the baby
latched on,  I don't understand what's changed or where to go from
here.  Any suggestions?

Thanks,  Bev Solow