Dear Chayn,
 
I'm struck by the fact that baby nurse well at night and wonder if he's  
responding to the traumas of repeated clipping and on somewhat of a nursing  
strike.  Or in his case, a feeding strike, since he's having trouble with  bottles 
as well.  I wonder if mom wore him during the day and had her  breast 
available without any pressure to nurse and all the other interventions  for nursing 
strikes, if he could be gentled back to breast.  Poor tyke  seems to want to 
suck since he's sucking his fingers, but he may have memory of  discomfort post 
frenotomies and this keeps him from doing so, unless he's sleepy  and not 
thinking about it much during the night.  Has mom tried duplicating  her nighttime 
nursing position in the daytime, or is there a difference?  
 
You said prior to frenotomy that he sounded congested but don't mention  
whether this is still occurring?  I'd be very reluctant to even do tongue  
strengthening exercises with this baby because to me he sounds orally defensive  
while he's alert and awake.  Can mom see you again for a re-eval so you can  
observe his behavior?  Maybe CST would be helpful to release pent up  emotions and 
also help with muscle use.  Homeopathy could be helpful for  the emotional 
factors.  
 
I think I'd try this approach for several days and then if ineffective  
investigate structural anomalies but my sense is more invasive interventions  might 
just put this little guy over the edge.  One other thought, if baby  is 
slinged and observes mom drinking from a glass/cup he might want to imitate  her 
and begin daytime use of her milk in a cup or glass.  Hope these ideas  are 
helpful.
 
Barbara Latterner, BSN, RN, IBCLC



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