In a message dated 6/6/2006 11:06:25 A.M. Eastern Standard Time, Jaye
Simpson, IBCLC writes: BUT my question is why would a full term
baby (now 6.5 wks old) have this latch that reminds me of a premie who needs
a nipple shield to maintain suction and stability? Maybe I am just really
tired lately (I am, actually) but what am I missing here? Could the higher
than average palate (which isn't the highest I've ever seen) be causing this
issue?
Jaye, YES!
I've seen and worked with several babies like this over the years. Several
of these families had subsequent (or previous) babies with the same problem,
just different severity and/or management. Sometimes they cannot get all the
milk and need supplement long term even with a shield. A shield helps some
of these babies a lot in my experience, though feedings may take longer than
average for the duration of breastfeeding.
And if it isn't the palate, your management will still work. If
cranial-sacral manipulation is an option, it might also be worth checking.
I also would like to point out that some of the babies I see on post-partum
rounds in the hospital are sucking ineffective from the beginning (like this
baby probably was). They become adversive to the breast because they cannot
make it work. I see this happen even if no bottles are given or the
breastfeeding help was sensitive and skilled. (I believe mom often feels frustrated
with the help that is "pushing" because she knows at some level, like the
baby, that it isn't working.) I believe the adversion can be the first sign of
a breastfeeding suck or milk-supply problem that isn't recognized as such.
And, if mom is stringent about no supplements, the next day the weight loss
will show 10% or more and we know for sure what baby was trying to tell us.
With the suck problems present from birth, the babies may take a long time
(weeks) to get to full effective breastfeeding, just as if they had been
premature. So, if I see slow and steady progress, I am encouraged. Many of them
progress in the time frame you saw here and I suspect high doses of labor
meds when baby was born as this seems to be a consistent factor. Weaning off
the shield varies according to whether the baby needs it for milk transfer or
not. I'm guessing you are wanting to clarify the cause of the suck problem so
you can decide how to best advise mom in terms of expectations and how hard
to keep up the practice of latching without the shield in the hopes of not
needing it eventually. --- wisdom to you!
And this case is just another reason I like test weights and shields in the
tool kit of a wise LC....
Natalie Shenk, BS, IBCLC
Findlay OH USA
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