On Fri, 12 May 1995, Catherine Watson Genna, IBCLC wrote:

> Lisa:
> For poor lip seal, I have found it helpful to have mom gently tap around
> outside baby's mouth in a circle (above the orbicularis oris muscle) to
> increase it's muscle tone immediately before feeding.

Don't think muscle tone is the problem, but more baby's confusions as to
what to do. He will extrude his jaw too much at times, and tongue changes
position and action during feed. Interestingly, baby does best when he is
drowsy, gets worse when he is totally awake and alert.  However, I
will try this suggestion just in case I've missed something.....!

>For the tongue, I would
> recommend sublingual pressure (a fingertip placed GENTLY under the chin, just
> behind the mandible, to give input and support to the muscles of the tongue)

I did try this a few different times, but found no improvement.

> From all the things you said about this baby, he sounds very
> hypotonic.

I've looked him over carefully, and though I am not a doctor, he doesn't
seem hypotonic to me. Muscle tone appears fine, and I see the strange
suck as not sloppy, but more confused.

>  Does this baby sweat a lot while nursing?  vomit a lot?

Haven't noted the sweating. No vomiting. I have pondered the referral to
an NDT/OT, but since baby is improving, I will wait.

Thanks for the suggestions and analysis! -Lisa


******************************************************************************
Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

******************************************************************************