In my experience high palates have been the one problem that I've NOT gotten
any better at!  I remember as a brand new Private Practice IBCLC in St.
Louis, Missouri - 1986 - I had a mother with a baby in my office who was
failure to thrive - but mom could hand express a BUNCH - which is why the
baby was not in the hospital - I called everyone I knew at the time,
including Kittie Frantz and Chele Marmet (and the cost of long distance
calls at that time was nothing to sneeze at!).  Other than finding someone
who could make an obturator (which we agreed would probably not be all that
helpful as baby's head grows so fast that an new one would have to be fitted
about one every 2 - 3 weeks) we could not think of anything.

I finally just had mom continuously hand express (sore nipples were not a
problem for this third-time breastfeeding mom) rather than try to let the
baby nurse part of the time.  No need to pump and mom had plenty of milk -
baby just wasn't getting it!

Last week I was called by a mom whose SEVENTH breastfed baby was in the
hospital with failure to thrive - again this baby had a high palate!  By the
time I was in the picture (4 months of age) mom's milk supply was very
diminished and pressure by the "system" including veiled threats of
Children's Protective Services have probably caused her to quit.  I have
provided her with a breast pump, information to let her know WHY this
happened (the reasons for the delay in medical care and a referral to me are
long and involved), and my support in whatever she decides to do.  

Baby has a "bubble" palate and the tongue has a slightly short frenulum and
is really "embedded" to the lower jaw - the kind that would probably require
Z-plasty and not just frenulotomy.  (I'm NOT diagnosing...just trying to
give you a better picture of what I saw!)

Wish I had better suggestions - but these cases DO have me stymied!

So my usual recommendations for these cases are:
Pump - feed whatever way you can - hope that baby's oral growth develops
enough to allow better latch before mom gets to the point where she gives
up!  

I've had SOME success if I get to the case early enough to give mom a pump
and babies DO seem to get better at milking the breast without hurting the
nipple when the breasts are "overfull" - so moms continue to pump after
every feed so that they actually are producing more than their babies need.
(Moms then freeze the excess milk for later or donate milk to a milk bank!)

Jeanette Panchula, BSW, RN, IBCLC
California, USA
 

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

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html