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From:
"Jaye Simpson, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 3 Mar 2009 13:39:27 -0800
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HI All,

 

I have a very tough case I have been working with for several months.  Baby
is now 13 months old.  Mom has NEVER had pain free feeding - bf with a
nipple shield even now.  Nipples have been painful and swollen for many,
many months - at one point was dx with a low-level bacterial infection and
put on antibiotics - they didn't help much.  Thrush was ruled in, treated
for that but still has this chronic pain with every feed.  Baby still bf at
least 16 times per 24 hours.  Growth is great, she is healthy and on target
in all areas.

 

Initially saw them at 6 months (tho they had been coming to my mommy group
for 5 months and I told her she needed a full on consult but she chose not
to until her pain was so bad that she gave in and saw me).  Baby had a t-t
that was missed initially, (there were other more pressing health issues at
that time for both mom and baby) then caught at 2 or 3 months I think - was
clipped but not enough.  

 

At 6 months when I saw them and did a full evaluation I found a still very
tight frenulum which I referred for another clipping, an odd palate shape
(like an upside down 'V') and VERY tight muscles throughout babies body.
Referred her out for muscle work.  Mom was unable to get frenulum evaluated
and clipped until baby was almost 8 months old.  ENT said it was tight but
not a big deal, could be affecting bf but not necessary to clip (groan!) but
they would if mom insisted and dx the palate issues as a torus anomoly.
(Doesn't look like any torus I've ever seen)  She saw one gal for massage
therapy but was not too thrilled with her so I referred her to another gal
who does Bowen Therapy and has had good success with multiple body issues
but not the suck or pain with BF.

 

Clipping the frenulum made some difference.  But baby's suck has not changed
enough (or at all).  I explained to mom that at this point since all the
work was done so very late, that tho there is now the ability to move the
tongue properly, she is still sucking the way she is out of habit.  Baby
will not allow suck training (hasn't since t-t last clipped 5 months ago)
and I am at a loss.

 

What do I do with them now?  Do I refer to speech therapist?  Is there a
resource out there to help retrain a proper suck in a 13 month old?  Baby
can eat solids just fine, is babbling and starting to talk.she simply (ha!)
hurts her mom when she nurses.  I personally think that the funky palate
shape (that 'V' is sharp and pointy!) is part of the issue as well as habit
for sucking motions.  

 

Thoughts?  


Thank you!
J

 

PS - I LOVE Cathy Genna's book Supporting Sucking Skills.  I also just
bought the book on Tongue Ties that was recommended last week.  It is easy
to read and easy to understand.  I have to say I am liking it.  It has a bit
of a different approach and good information.  The pictures are fabulous.  I
dx my own son with t-t last year when watching him eat an ice-cream cone.
He was born with a high bubble-palate and dysfunctional suck 14.5 yrs ago
and tore me to shreds.  The t-t was missed.  I am hoping to talk him in to
letting me take some good pics of his tongue 'skills' and his palate and
perhaps put them to good use.  If it weren't for him, I wouldn't be doing
this LC thing today.  :-)  

 

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

 


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