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Date: | Tue, 26 Apr 2005 23:01:44 -0400 |
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It's not the Turner's that is the big problem here, it's the cleft. The
SNS will not help, as this baby can only make compression (positive
pressure) and not negative pressure. Milk will need to be actively
expressed into her mouth, either by syringe and tube while at the breast
or by mom hand expressing milk from the breast while the baby sucks.
Neither is going to be very efficient, and mom will need to pump as well.
There is at least one team of docs who perform early repair (in the
first week of life) for palatal clefts, Dr. Michael Denk is one of them,
and he's in Virginia. That would be an option for these parents who are
committed to breastfeeding.
If they choose not to pursue early repair, you can help mom come up with
a pumping plan that will maintain her milk supply, help baby feed in a
way that encourages her to use her tongue properly, and maintain some at
breast time so baby is willing to go to breast after surgery, and for
possible reshaping of the mouth (see Brian Palmer's work on
breastfeeding shaping the oral cavity).
As far as the Turner's, the baby might be a little lower tone, and the
short neck might make positioning a little more challenging at first,
but they tend to do well.
Catherine Watson Genna, IBCLC NYC
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