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Subject:
From:
Mary-Jane Sackett <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 21 Nov 2011 07:23:40 -0500
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Dear Jessica and listmates,
 
 I would try a nipple shield to see if the infant is able to better  use 
the tongue. I am beginning to think that many of the sucking dysfunctions I  
am seeing are caused by limited/decreased tongue function and mobility due  
to the trickier and more subtle Types II-IV, not the easy to spot Type I  TT. 
I think a baby who cannot maintain a deep latch, even when the mother is  
assisted by the LC, or who repeatedly leaves the nipple compressed or new  
lipstick tube-shaped, has a TT. I am finding that this is happening even with 
a  mom with great nipple/areola anatomy. This is so hard for the parents to  
comprehend. I do give them the info from Dr. Kotlow. It is hard enough to 
get  the pediatricians around here to think that this is important and make a 
 referral for an evaluation or release of Type I. I don't have much hope  
that they will begin to realize there is a reason for a baby's struggles with 
 breastfeeding when the problem is not too visible. 
 
Let us know how this case progresses.
 
Mary-Jane Sackett, RN, IBCLC
Pittsfield, MA
 

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