So it turned out to be a narrow palate rather that "shallow" -- although I have seen references to shallow palates lately, and can't quite picture how that would be a problem.

It's always a "chicken-and-egg" kind of detective work -- why did this baby have so much trouble gaining weight in the first place? But sometimes when we tune in late on a situation, and a baby is soo underweight, how can we really judge their feeding skills until they're gaining solidly for a while? Sometimes a baby who seems terribly disorganized and restricted does just fine once we've boosted the weight gain.  If a baby gets off the path with gain in the first weeks because of a  rough birth, or just hanging off the end of the nipple, it's hard for them to turn the situation around without help, even if the anatomical variations aren't the deciding factor. 

It does seem that these motivated parents are moving forward.  So it will be interesting to hear if the laser revision is what makes the difference.  (Although the baby is gaining now, too, so it might be hard to judge.)

Good luck to us all.

Margaret Wills, IBCLC, Maryland



> Date:    Sat, 7 Jun 2014 23:43:04 -0500
> From:    Ruth Piatak <[log in to unmask]>
> Subject: Shallow palate and extremely active 6-week-old
> 
> An update on the baby who was not back to birth weight by 6 weeks:
> 
> I saw them Thursday evening. Baby was indeed very thin, and stayed
> "latched" to the nipple shield and awake during most of the meeting. Not
> lethargic at all. Noticeable coronal cranial sutures.
> 
> Baby was able to cheerfully interact with mother, including a big smile --
> revealing severe PTT and bubble palate. Mother had apparently confused
> shallow and narrow. Tongue had no cupping of the silicone nipple, no
> lateral movement to speak of, and no ability to offer mother's nipple more
> than a restrained lick though my colleague and I helped with positioning.
> Mother responded positively to my observations and was eager for links to
> learn more.
> 
> Friday's visit to doctor revealed triple feeding had enabled baby to gain
> an average of an ounce a day since previous weight check. When mother
> discussed my observations with LC, LC concurred that PTT "makes total
> sense". Mother and father have had a good look at Dr. Ghaheri's blogs, are
> setting up plans for laser revision of baby's PTT, and plan to continue
> with OMT.
> 
> Another mother in our Facebook group reports her baby has been identified
> as having a bubble palate, but is still absorbing that this may mean tongue
> revision is necessary. She is seeing a different LC in the same community.
> Is it still thought by many that a poorly spread palate in a newborn can be
> found separately from a tongue with inadequate range of motion?!?
> 
> Ruth
> 
> -- 
> Ruth Piatak, BA, MS, LLLL, IBCLC
> [log in to unmask]
> 
>   

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