Permission to post from parents....
I have been working with a baby who has me stumped. The baby is now 3 days
old. Labor uneventful, short duration epidural, spontaneous birth. Baby
is full term with no obvious problems.
When I saw mom & baby on day 2, mom stated she thought all was well but
just wanted to verify latch...upon inspection, baby found to be at breast
but not latched well (or really at all). The upper lip appeared to be in a
normal position flanged out and over the breast, the lower lip was pulled
into the mouth, the chin receded and the mouth esentially closed with the
tip of the nipple resting on the chin....baby was making sucking motions,
but was sucking on the tounge...mom did not realize this.
We tried to attach properly and each time, as the baby closed her motuh and
took the first suck, she drew in the lower lip and chin and essetially
pulled off and went to the same position described above. Tried a sheild
with similar results. Baby would suck normallly on dads finger.
Upon carful oral inspection, mouth seems normal...palate, lips, frenulum
and jaw all appear within normal limits. When baby is awake, she holds her
jaw and lips in a normal way...when sleeping, she brings in the lower jaw
and lip. This baby does not appear to have a underdeveloped chin when you
look at her when she is awake.
They were going home yesterday...so we started formula supplements and
began pumping as the baby had not really ever latched at all, in addition
to attempting nursing. At follow up exam today...baby was no better and
has now lost quite a bit of weight (no surprise there...the parents did not
believe me yesterday that the baby was not nursing and did not give much
formula)...increased supplements suggested. Interestingly, with a bottle,
the baby behaves in the same fashion as with the breast and I suspect she
will be a challange to feed either way.
I will see mom and baby again tomorrow. So far I have suggested lots of
skin to skin, pump to maintain the supply, attempt to nurse every 2-3hrs,
keep time at the breast pleasant... and supplement to grow.
Have any of you ever run across this before...any suggestions???
Thanks,
Lori Peters RN/IBCLC
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