Hi Ellen,
you write;
>>Digital proved that tongue was not covering gums and I suggested finger
walking exercises on tongue and finger feeding with syringe<<

This isn't meant to question your professional judgement in any way but I am
wondering how the digital exam "proves" that the tongue isn't extending
beyond the gum line. This coupled with the fact that the Mom has such pain
definitely seems to *suggest* it but I question the accepted idea that what a
baby does with a finger in his mouth mimics what he is doing with a nipple.
This has always been a problem I have with digital exams or manipulation of
any kind... although I would love to be *convinced* and thus develop another
valuable tool in my repertoire!
I have had at least one Mom with similar presentation, the most recent I
worked with for quite a while before she went to bottles of EBM. She was
definitely committed to the breast but nothing helped. I might try a nipple
shield though.
Just wondering...does anything about the session appear abnormal or unusual?
My above baby had very poor state control and would become extremely
agitated; tense and hypertonic with latch and would clamp down on nipple
despite very well executed comfort measures, for a period of several weeks
without change. Interestingly she was very relaxed with a bottle nipple.
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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