Remember it's not so much the palate shape that's problematic, but the 
tongue movements (or lack thereof) that caused the palate shape.  Babies 
who were intubated have the shape of the tube pressed into their palates 
for some time afterward.  If they have sufficient muscle tone, they are 
generally able to breastfeed with some time and patience. 
Now that Zachary is off the vent, it can be very helpful to give him a 
pacifier to suck while he is being gavage fed.  This will help couple 
sucking with feeling satiated, and give his tongue some exercise.  Once 
he can maintain his O2 sats during non-nutritive sucking, he can be put 
to the freshly pumped breast during gavage feeds, so that he gets to 
learn how to suck without the challenge of integrating swallowing and 
breathing, which a baby who needs high flow oxygen is generally not yet 
up to.  Even having some skin to skin care against mom's breasts can be 
a good first start with a baby this little, and this can have positive 
developmental consequences too.

When he's up to just-pumped breast, a little skin to skin to stabilize 
him first is a good idea, then position him at breast and hold him there 
without trying to make him do anything.  Just being moved is sometimes 
enough of a challenge for very early little guys.  Smelling a drop of 
milk expressed onto the nipple is a good next step, and licking or 
nuzzling the nipple may be his first step toward breastfeeding.

Maintaining a very generous supply is likely to be the best insurance 
that he will someday learn to breastfeed.  Bravo to his Mommy.
Catherine Watson Genna, IBCLC  NYC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html