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Mon, 16 Jan 2006 21:39:12 -0600 |
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wow---sounds like lots going on here.
1) Yeast--if baby has thrush and mom has an open crack at the base of the
nipple, I would treat both with 1/2% gentian violet-5 days mom and 3 days
baby once a day. Although yeast probably did not "cause" the cracks, it is
probably at least contributing to a delay in healing.
2) Epiglottis vs. uvula--I would assume you are actually talking about the
baby's uvula...hanging down in the back of his mouth? The epiglottis is
generally difficult to see. I am assuming the pedi is talking about a
"bifid uvula", which often exists with a submucosal cleft in the palate.
This usually makes maintaining latch and milk removal extremely
difficult...which would explain "constant" feedings and clicking and nipple
damage. A nipple shield might help if this is the case.
3) I would lift the baby's tongue and look for a tongue-tie--it is one
thing someone could actually "fix". If present, you could try a nipple
shield in the meantime to see if it helps the baby "hang on" without
clicking.
4) cup-feeding--I would not see why cup-feeding would be the preferred
method in a baby who has baan nursing for 8 weeks. I would use a bottle, to
make it easier for mom. Get nipple all the way into mouth.
5) Large, deep cracks at base of nipple--as I have said before, I have
found it is useful to have moms use the shells with the smallest openings
(actually intended for inverted nipples) to hold the cracks all the way open
between feedings. This speeds healing, which has to take place from the
base of the nipple upwards, and often takes weeks. I would throw in
"all-purpose nipple ointment" applied after each feeding.
just my thoughts--good luck!
Kathy Leeper, MD, IBCLC
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