Louanne
I think Kathleen Bruce gave you a great response and I basically agree w/
her. What is significant to me is that this happened w/ both the mother;s
children. From the info you gave us I think I would have these as the
"differential diagnoses" (not necessarily in this order, but asking a few
more questions like KB asked to see where to go first):
1. Raynaud's or similar phenomenon - this would be painful and cause
blanching but maybe the baby would still get the milk and wt loss would not
be a big problem?
2. sexual abuse or other psychosocial issues - I don't know if this would
cause blanching; also wt gain problems could occur w/ impaired MER
3. variation of infant oral anatomy/palate that was present in both babies -
would fit the picture of pain, low gain, blanching etc and also could be
something that contributed to the apnea?
4. yeast - why would this cause low gain unless MER is very impaired due to
pain or if baby has/had yeast too and doesn't suck well.
Good luck w/ this case; hope lactnet comes thru for you.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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