Interesting case I would like some insight on.
I had a mom who delivered a healthy baby. She was a primip, and both preg
and labor/delv were uneventful. This mom was from Mexico and what she knew
of her family history was also unremarkable. The baby appeared to be
suckling well at the breast according to mom and staff nurses. However mom
developed engorgement and infant dehydration. Obviously milk transfer was
not accruing. On oral exam revealed the oral structure was normal. Suck
assessment revealed very poor oral tone. No tongue movement noted just and
up and down movement of the lower jaw. Poor seal of lips and almost no neg.
pressure. When bottle fed this infant lost a lot of the feeding due to the
poor seal. It also had problems with its suck swallow coordination. We
started mom pumping and using a Haberman feeder . We also started suck
training and having mom wear the infant 4 to 5 hrs. Per day. We followed
this mom for 2 weeks in our out pt. Clinic at which time the infant was able
to successfully breastfeed with no need for ABM. We chalked this up to the
weird but interesting group.
This week I again had a mom also from Mexico and a primip. She also had a
neg. history and a normal labor and delivery. Her infant also had a decrease
urine out put. Oral axam also revealed same type of problems as the above
infant.
Has anybody seen anything like this before. Is it coincident that both moms
are Hispanic. Any other ideas for increasing oral tone.
Thanks for your help
Toni Lietzinger Rn IBCLC

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