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Subject:
From:
Khalid Aziz <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 30 Apr 1997 01:41:43 -0400
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Norma,

I saw your note and thought that I would respond from my clinical experience.

Firstly, CP, being a disorder of movement, tone or posture, rarely presents
with certainty in the first 6 months of life.  There may be suspicions of a
diagnosis but this would be difficult to prove until more purposeful
movement would normally occur.  Infants who are subsequently discovered to
have CP may be poor feeders regardless of the method of feeding.

Secondly, CP is not a diagnosis, but a collection of clinical findings that
can have many different causes.  Most children with CP have normal birth
and perinatal histories and no cause can be found.  Some children have an
identified cause such as intracranial lesions found in very low birthweight
infants, or meningitis, or head injury in infancy.

Thirdly, CP varies in severity and site.  The commonest types mainly affect
the legs (spastic diplegia) or one side of the body (hemiplegia).  Speech
and swallowing are often spared.

As a result CP is rarely considered at the time of initiation of
breastfeeding.  If it discovered at 4 to 8 months there is no reason to
discontinue nursing.  Children with motor impairment would also greatly
benefit from the advantages of breastfeeding.

Rarely there are sucking or swallowing difficulties identified at birth
which are a prelude to the diagnosis of CP.  The infants fail to thrive
regardless of the mode of feeding.  The mother is usually convinced that
there is "something wrong" with their child.  These infants require
multidisciplinary assessment.  Parents require a lot of support.  These
babies can sometimes cup feed but often require tube feeds.  Fortunately
this is rare.  I have usually involved a "feeding team" with
multidisciplinary input in these cases:  speech pathologists and
occupational therapists in children's hospitals have expertise in this area
and can be a resource, I hope that your local one can help.  Good luck.  Khalid

Khalid Aziz
Memorial University of Newfoundland

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