An update on the baby who was not back to birth weight by 6 weeks:

I saw them Thursday evening. Baby was indeed very thin, and stayed
"latched" to the nipple shield and awake during most of the meeting. Not
lethargic at all. Noticeable coronal cranial sutures.

Baby was able to cheerfully interact with mother, including a big smile --
revealing severe PTT and bubble palate. Mother had apparently confused
shallow and narrow. Tongue had no cupping of the silicone nipple, no
lateral movement to speak of, and no ability to offer mother's nipple more
than a restrained lick though my colleague and I helped with positioning.
Mother responded positively to my observations and was eager for links to
learn more.

Friday's visit to doctor revealed triple feeding had enabled baby to gain
an average of an ounce a day since previous weight check. When mother
discussed my observations with LC, LC concurred that PTT "makes total
sense". Mother and father have had a good look at Dr. Ghaheri's blogs, are
setting up plans for laser revision of baby's PTT, and plan to continue
with OMT.

Another mother in our Facebook group reports her baby has been identified
as having a bubble palate, but is still absorbing that this may mean tongue
revision is necessary. She is seeing a different LC in the same community.
Is it still thought by many that a poorly spread palate in a newborn can be
found separately from a tongue with inadequate range of motion?!?

Ruth

-- 
Ruth Piatak, BA, MS, LLLL, IBCLC
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