Please consider refering to a reputable Chiropractor for a possible cranial sacrial adjustment.
Date: Wed, 26 Jul 2006 01:58:42 EDT
From: Pamela Mazzella Di Bosco <[log in to unmask]>
Subject: weak lips and cheeks affecting latch?
Looking for input about helping a baby latch who has been unwilling/unable
since birth to take the breast. When I first saw the couple, baby was only 4
days old and absolutely refused to even attempt to breastfeed. This is after
two days of non stop skin to skin, co sleeping included. Mom is an
experienced breastfeeding mother of 4 previous children who took to breast
immediately at birth, nursed for years, etc. This baby would not latch in the hospital
after normal vaginal delivery. Mom began pumping and feeding the baby with
a spoon and continued to do so for days. Still no latching baby. Finally,
mom frustrated and baby frustrated, mom used a bottle with paced feeding, slow
flow nipple, etc.
This baby was so tense and tight fisted and just screamed when placed even
in the proximity of the breast. Even on the bottle the baby would not really
suck, more like a chewing chompy motion. Tongue would not relax, but no
tongue tie, and when not feeding baby will put the tongue way out. Mom decides
to pump, bottle feed for a bit and wait and continue to try to offer the
breast while protecting milk supply and feeding her baby. Two weeks, and the baby
is just now relaxing in her arms when in front of the breast, fists no
longer tight, arms and body no longer so tense and stiff. They come to see me
again, and honestly it was like a new baby all calm and relaxed. Still, not
latching. I have seen a lot of babies over the years, but only a few who do not
make the connection between drawing in a nipple to suck even on a bottle.
This baby used the tongue to try to force the bottle out also.
Okay, so what to do? Outside my capablity. I am totally aware something is
wrong, not a therapist for newborn sucking disorders, so cannot figure out
what is up with this baby. Ask mom to take the baby to the pediatrician to
rule out any reason to protect airway. (Mom says when baby spits up,
occasionally milk does come through the nose quite a bit, so at least she should rule
out any possibility of a hidden cleft---not to mention I am looking for a
good reason for this baby to not want to relax and eat.) Next, to take the baby
to a specialist (good luck in finding one that understands breastfeeding).
Pediatrician says no reason for the baby to be protecting air way. Okay,
one possibility not correct. On to the speech therapist specializing in
babies. Her conclusion? Baby can suck, swallow and breathe just fine (of course
only seen at the bottle, since she did not ask to see how the baby reacted to
the breast, only wanted to see how the baby bottle fed) and said the tongue
was within range of normal, but the lips and cheek in relation to the tongue
were weak. Also, stated 'no sign of sensitivity disorder'. was wrtitten (which
is at least one thing we can rule out?) Her diagnosis was that there is
nothing wrong, and the baby just wants the bottle. Told the mom to support the
cheeks during feedings to help equalize the strength of the cheeks and the
tongue. Those were the exact words she wrote for the mom, and basically told
her that her baby just doesn't want to suck except for reward, so the breast
does not offer reward. (Not making sense to me as the mom is a fountain of
milk and easily expresses more than a full supply for this baby and can easily
hand express milk into the baby's mouth, but baby still will not take the
breast.)
Quitting is not happening. This is a mom who breastfeeds in years not
months and she is determined to keep working until her baby does breastfeed. But,
since my brain always goes back to "A baby who cannot breastfeed is a baby
with something wrong, because breastfeeding is the biological normal behavior
to eat and survive", what is missing here? I have a plan in mind for mom to
try next since the therapist says there is nothing wrong and baby should be
able to breastfeed, but am looking for other ideas too. And wondering if the
tongue and cheeks being week would make the baby unwilling, unable to latch
to a breast as opposed to tolerating the bottle (which in my uneducated
opinion the baby also does not appear to use the way a baby typically sucks on a
bottle.) I do not think the bottle is the culprit here because it was the last
thing used to make feedings easier and I have worked with far too many
babies who have had weeks of bottles go to breast easily once the bottle feeding
method was changed and the option of breastfeeding was offered properly. This
baby does not suck the way a breastfeeding baby should, and even though the
therapist says the baby is 'within range of normal' for behavior, maybe that
range of normal is not based on normal at all, but is based on the ability to
bottlefeed? I may not know what is wrong, but I am fairly certain when
something is not right.
Thanks so much,
Pam MazzelalDiBosco, IBCLC, RLC
Florida, USA
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