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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 30 Oct 2004 20:11:45 -0400
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text/plain
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Cheryl,
Occupational therapists think that sucking changes over the first 6
months of life.  We know that this occurs for bottle fed infants, they
start to use a more up and down motion of the tongue to get milk out by
about 3-6 months.  For breastfeeding infants, we are not sure, we'll
have to wait for Donna Ramsey to tackle that.  Mothers who breastfeed
toddlers certainly report that it feels different from breastfeeding a
newborn.

I would not be surprised if compensations in sucking skills due to OAMER
or even a baby's inability to handle a normal flow might have
consequences for handling solids.  I have seen some tongue tied infants
in my practice who breastfed fairly well, but then had great difficulty
handling solids (refusal, choking, etc).  Certainly the tongue needs to
groove to form chewed solids into a bolus for a controlled swallow just
like it does for liquids.  If that grooving is deficient, there might be
problems.  Sensory issues could cause infants to dislike certain
textures, as can swallowing issues.  It is not at all uncommon for
people to have difficulty swallowing certain textures of food safely,
while having no problems with others.  OT's classify foods as thin
liquids, thick liquids, purees, crunchy, etc.  Some people can handle
thick liquids but not thin, and vice-versa.

Chewing also involves lateral movements of the tongue to push the food
to the chewing surfaces of the teeth.  A tongue tied infant who could
manage to feed by chewing mom's breast might not have the lateralization
ability to push food to the teeth.
So much to know, so little research!
Catherine Watson Genna, IBCLC  NYC

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