Hi. I am working with a mom and baby about 48 hours old. This baby makes
classic swallowing sounds (the "kha, kha" type), but I found out today that
he does this even when sucking a finger. Mom was very happy yesterday
because I told her that sound is baby swallowing. Because of breastfeeding
problems since then, I did a finger assessment since baby keeps coming off
the breast. With every suck he made a swallowing sound. I have only been
working with 1-2 day old babies for 6 months now but I have worked with
many babies who have moms with a full milk supply and I am very familiar
with that swallowing sound (of course my own babies too!). This
baby's "swallows" sound exactly like that of a baby drinking from a full
breast (not the almost inaudible swallows we sometimes hear in the first
day or two)--and they are with every suck--but of course on the finger
there is nothing for him to swallow.  What else could be responsible for
this?  Is he swallowing air?

Just a little history. Baby was distressed during labor. Mom mentioned he
didn't do well during contractions.  Born vaginally, but taken directly to
nursery and put on monitors for maybe 12 hours. Abdomen distended. Doctors
concerned about sepsis so antibiotics were started. As of yesterday baby
was taken to mom's room for first feeding and did well we thought other
than not staying attached to breast for more than 30 secs to a minute.
During the night the glucose went to 25 so IV glucose solution was started
and baby was finger fed formula.

As of this morning, mom started breastfeeding again. Ped said baby is doing
fine health-wise. I assisted with feeding and baby still comes off of the
breast. Not fussy, just pulls off and will calmly go back on again when
helped.  Mom said he does arch a little while at the breast.  Mom on her
back and baby lying across her seems to work best--he stays on a little
longer. He detaches easily from the breast so I don't think his seal is
great.

I am just wondering if this very audible swallowing sound (especially with
finger) is a sign of something--especially since he is having some
breastfeeding difficulty and a history of other problems. He seems content
at the breast and with finger--he doesn't seem like he can't breathe or
anything.  According to nurses, his reflexes seem to be normal. Although,
they have noticed some possible "posturing", but not sure if it really is
at this point.  Sorry this is so long, but it is hard to explain in writing.

Thanks again,

Christine Lichte  LLL leader, CBE, IBCLC 2003 candidate

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