Baby started getting hungry and started to root for breast.  From what I =
was
told, baby couldn't latch on to the breast and would push away and scream=
at
breast.  They said she would pinch lips closed and refuse to suck.  A nip=
ple
shield was tried without much success as baby would just suck on the end =
of
it.  Suction was said to be more chewing than sucking.

When I saw this mom, she was over 48 hours pp.  Baby was well awake and
rooting.  She opened wide and did latch to the breast well but was making=

these awful smacking loud noises sounding almost as if  she was smacking =
her
tongue from the roof of her mouth to the bottom of it.  She was putting n=
o
suction on the nipple and was on a few occasions hurting mom by bitting d=
own
or clapping down on the nipple.  Every once in a while, she would get in =
a
few sucks  but would go on to the same clicking noises.  The sucks were n=
ot
very strong or adequate to remove milk.  I did an oral exam and found no
abnormality except a short frenulum that seemed to be tied rater in the b=
ack
of the tongue.  When attempting finger sucking, baby could not extend ton=
gue
further than the lower lip.  She would cup finger with tongue but you had=
to
try several time before she did it right and even then, it wasn't a full
cupping like other babies usually do.  Suction was good.  Baby stayed cal=
m
while attempting to breastfeed and did not push away from breast.

What I recommended this mom do is try baby at the bare breast for at leas=
t a
couple of minutes but not overly because nipples were starting to get sor=
e
and baby was chewing them out.  I said if baby wasn't getting it after a =
few
minutes to finger feed baby while holding baby close to breast.  Do lots =
of
skin-to-skin with baby and to pump after every attempt at the breast.  Tu=
be
at the breast didn't work either so that is why I suggested ff.  I also
showed mom how to stimulate suck and how to try to do suck training with
baby to help with tongue extension and cupping.  I asked the nursery nurs=
e
to have peds look at the frenulum but I guess she never did.  I guess mom=

ended up giving up and offering bottle.

Did I miss anything?  What else could I have done?  Our peds aren't too
willing to clip frenulums....

Thanks for your imput!!!

Celine Cormier, RN, BN, IBCLC




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