In a message dated 12/15/2004 12:07:14 AM Eastern Standard Time,
[log in to unmask] writes:
tongue tie (even a far posterior one (type 4) can prevent tongue
elevation beyond the very tongue tip... With these conditions, even a
perfect latch will not lead to perfect sucking. Sometimes the sneakiest
tongue ties (type 3 and 4 that no one ever notices) can cause worse
tongue retraction and chewing of mom than the more obvious classical
"heart shaped tongue" type 1.
... It's hard to get the pediatrician to go along and
let the mom have a referral to a specialist, because some of them don't
even "believe in" difficulties from obvious tongue tie!
Sigh.
Catherine Watson Genna, IBCLC NYC
Occasionally it seems the result of "Karma" that I've read a Lactnet post
on a condition that pops up in a mom the very next day:
I just saw a mom-pp day 7- she'd developed deep nipple/areolar junction
cracks by day 2 in hosp- all who saw baby during the first week observed great
nipple shape, a great latch, great positioning, great transfer of milk, and
extensive damage. By day 7, she had had to use form d/t nipple damage so severe
that even pumping was causing more damage-(avulsion-type along the deep
cracks)-she was on Dicloxacillin d/t beginning mastitis (no surprise there), and
trying to hand express without success-now becoming engorged. On observation,
baby had no observavble tongue-tie; closer exam showed tip mobility and
elevation perfect but mid-tongue stayed flat and wide w/little ability to cup-
I had just read the AAP link on tongue-tie recently posted-(Thanks
Catherine- the pics are fabulous!) and I was sure this was a posterior tie.
Since I couldn't see an obvious frenulum under the tongue, I didn't think
we'd find a pedi who'd agree to clipping-
Mom had tried n.shield during the week, but reported infant didn't like it,
and mashed it flat, but agrred to try it again. Firts I inverted nipple
shield deeply before putting on and popping it out so her cracks were well into
the shield cylinder. I then got babe really well positoned obliqely across
mom's chest with head tilted WAY back and jaw extended forward (what I've termed
"Pez Dispenser" position)- she got on deeply bottom-jaw first, suckled
without problems, and happily nursed- mom had NO pain for first time ever. Towards
end of nursing babe tends to revert to mashing, but mom can tell immediately
and detaches her.
She still needed to express residual milk, and even with larger flange, it
was extremely painful. So we tried pumping with nipple shield on- great
result- expressed easily, no pain! I don't know if anyone's treid this, but it
worked really well.
Thanks Lactnet-
Lucia Jenkins RN,IBCLC
Wakefield, Ma
"Never let the day see the setting sun without seeing some breastmilk run."
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