You might also consider:

- lip tie
- body work
- I feel a but funny suggesting this as Catherine Watson Genna Answered her
self and this comes from her book, I have found that her suggestion of
placing your finger in the fleshy part just behind the jaw bone,
and applying genital slightly firm pressure in an up and out direction has
been helpful in a few babies with whom I did not manege to identify the
problem.

With kind regards

Naomi Sallé IBCLC LLL

>Dear wise ones,
>I have a lovely couplet that I have been trying to help for over 3 months
>now and would love to have some feedback especially from those in private
>practice who work with older babies.  (I am a hospital based LC).  First
>time mother of a full term healthy baby born via c/s.  C/S was for failure
>to progress which means nothing here with over a 40% initial c/s rate but
>that is a story for another day.  Baby spent the first 3 days of life skin
>to skin and working w 2 experienced IBCLC's.  From the get go baby did not
>know how to latch.  She simply clenched her jaw and chomped, if anything.
>There was no visible tie, but we suspected a submucosal one.  Mother went
>home pumping and had frenulum cauterized by plastic surgeon. Mother did ot
>return for follow up with lactation until 2 weeks of age.  Fortunately, her
>milk supply has been and continues to be excellent. It was noted then that
>baby chomped on bottle as well.  Suck training was tried and, at our
>suggestion, she followed up w a speech therapist who felt the oral
>structures and suck were normal.
>Fast forward to last week when baby started to latch.  Mother had not even
>tried for several weeks when baby just started rooting on own.
>Unfortunately, the latch is not good and mothers nipples have become too
>painful to latch her.  Baby can stick out her tongue, palate seems slightly
>high but not very high. Mothers question to me is: can baby learn a correct
>latch at this age?  I question if the tongue might need revision, but
>mother doesn't want this. I appreciate any insights into this case.
>Mary Westra RN, IBCLC

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