Amy,

Yes, I have been concerned about other issues with this baby.  (sucking ability and coordination, etc.)  I am not specifically trained in this area, and I am well aware of this "hole" in my knowledge.  Something that I am working on for sure!  But I do know enough to recognize when things are not progressing normally as expected.

When I suggested pushing the milk with the syringe, I intended it to be only as a very temporary measure (a few hours to a day)  because baby was not sucking and needed to ingest something somehow.  At first, I thought this inability was purely do to lethargy that developed due to poor latch.  I thought that once baby had energy, we could improve latch, then everything would be fine.  That is not what happened.  Baby's energy returned, but she still cannot suck well.  I am aware that this is a huge red flag for other issues, and therefore have sent referrals for more specialized care.  But it takes time to see these people and in the meantime I am still working with this mom to try to help as best as I can.  And thank goodness for lactnet as a resource to draw from for my more complex cases!  I have learned SO MUCH here!

I will be seeing her again in a few days, will reassess the tongue (though after the 1st exam, I did not think there was a TT), and we will likely try a shield to see if the extra palate stimulation helps get her sucking and getting milk on her own.  It obviously would not be ideal, but feeding at the breast with a shield is better than mom having to continue to pump and feed away from the breast.  She is getting exhausted with this routine.

Jennifer Welch, IBCLC (2010), LLL (2006)
Montreal, QC

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