I've worked with two moms who's babies had problems latching and
suckling effectively b/c of exceptionally high narrow palates.  One was
the baby with the mild largynotracheomalacia that I've talked about
before, the other was a baby with no other issues.

In the 'no other issues' case, the mom's extremely abundant supply
really carried this baby for the first few weeks, I didn't see the baby
till six weeks- her supply had been set 'well', moms nipples were badly
damaged.    baby was also very fussy for long periods and was very
difficult to latch.  also diffficult to nurse - he was constantly coming
off the breast and was clearly frustrated. She was able to heal the
damage very very quickly by doing using sheilds for 2 days and moist
wound healing for the same amount of time.  after each feeding she would
apply lansinoh, a 2" square of saran wrap, then her bra to hold it in
place.   within 48 hours her nipples were *completely* healed and she
was able to go back to just breast.  we also significantly modified his
latch to an extreme asymetrical.  he still came off the breast a lot as
he had difficulty maintaining the negative pressure due to the shape of
his palate but it slowly got better and by three months he was nursing
easily.  no pumping or supplements were needed.  she hadn't gotten help
earlier b/c she just didn't know how significant the issues were and she
has a high tolerance for pain.  personally, I don't know how she did
it.  I couldn't believe she was still nursing as badly damaged as her
nipples were.  They're still nursing 3 yrs later.

The other case with the baby with laryngotracheomalacia:
by the time the mom sought help (her ped had been telling her that
everything was fine, just persevere....), her supply was very damaged
and her.....her nipples had healed b/c she was had pumped (didn't get
much) and bottlefed (a good bit of formula supplemented) a fair amount
for a few days.  we also worked on her latch and modified it
significantly.  he too was able to nurse with no sheild....latch
modifications and breast compression were enough to get him transfering
milk (using a lactaid also), mom had very elastic breasts so once things
were fixed, he was able to nurse well at the breast.  mom used
domperidone, herbs and the lactaid (with formula) for 5-6 mos, then
ditched the lactaid and formula, then finally at around 9 mos weaned off
the last of the domperidone with no dip in supply.

So that's my N=2

:)
katherine in atl

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