----- Original Message -----
From: "Dr. Leeper" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, January 04, 2009 3:16 AM
Subject: [LACTNET] Not sustaining strong suck, HELP NEEDED


**Hello Kathy,

> What is the baby's current weight in relation to birth weight?

**At or just over; last weight check wasn't available when I was there. I
will suggest a scale.

> Sounds most like a tongue-tie or submucous cleft of the palate.  Or are
> mom's nipple too large for baby?

**I paid a lot of attention to tongue movement, but nothing strange. Free
range of motion, active sticking out, coordinated suck as felt on my finger.
I'll immediately admit that I may not have enough experience yet to notice
subtle abnormalities, but she surely wasn't doing strange things with her
tongue. I don't suspect a submucous cleft either, but would have to
thoroughly check that again.
My gut feeling says it's something simple, something that needs breaking a
cycle, maybe expressing a lot and topping her off several times, so that she
feel satiety and sleeps well and then takes a good feeding after that. I'm
not sure, though, and it gives me a very uncomfortable feeling not being
able to come up with clear management suggestions... :-(
Anyone who cares to hand in (more) suggestions is welcomed!

Warmly,

Marianne Vanderveen, Netherlands

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