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Date: | Tue, 12 May 2009 09:37:18 -0700 |
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I am very far from an expert in the field of lactation, but since I have seen some babies with this very typical finding of tongue glued to the roof of the mouth I want to give my 2cc.
You mentioned that baby had an unusual position emerging from the womb and this is in consistency with what I know. Sometimes this position of the tongue can mean damage to one of the nerves enervating the tongue due to a difficult birth. The abnormal movement of the tongue may have the same reason - so maybe it is a good idea for this baby to be checked thoroughly for some kind of a nerve damage too.
Christina Yaneva
BF Peer Councellor
Bulgaria
--- On Mon, 5/11/09, Michele L. Crockett <[log in to unmask]> wrote:
> From: Michele L. Crockett <[log in to unmask]>
> Subject: what's going on? long story
> To: [log in to unmask]
> Date: Monday, May 11, 2009, 11:49 PM
> Help! With permission to post: I
> am working with a mom who is one of our WIC Peer Counselors
> and and experienced mom of 4 exclusively breastfed
> children. Baby #4 was born April 5th in an completely
> unmedicated home water birth---dad caught as midwife did not
> arrive prior to birth. Dad is not sure how baby presented
> but reported it didn't look 'right'. He may have had his
> hands on his cheeks (think of the kid in Home Alone with his
> hands on his cheeks!). He had quite a bit of bruising on
> that area of his face. No molding I could see 20 hours
> later. Weight 7'4".
>
>
>
> Mom has had uncomfortable latch issues with all kids that
> was likely caused by being 36-38 weeks gestation--all
> natural, not induced. Baby #4 was actually at 40 weeks.
> Other kids latch resolved with some basic position changes
> etc. Worked with this little guy with out much luck. His
> tongue was 'glued' to the roof of his mouth and he would not
> lower it. Mom had a Lactina for back-up and to in sure
> good breast emptying especially on day 2. Her production
> remains good, great MERs. Continued offering the breast
> and backing up with EBM via dropper when baby was frustrated
> or mom was. Had a brief episode with elevated jaundice
> resolved without any therapies.
>
>
>
> Saw mom and baby on day 6---dehydrated and losing weight!
> Baby was at 6'6" and did not look good. Latch awful.
> Tongue up, small mouth and barely could extend tongue to
> bottom gumline. It appears to me that the tongue is
> short? Chin is recessed but not more than her other
> children's were. Okay wet diapers/marginal stooling. Mom
> left with MD appointment the next morning for follow-up, and
> instructions to pump more frequently and supplement EBM 2 or
> more ozs. every nursing. MD confirmed my recommendations
> the next day although baby was not dehydrated by that time,
> fortunately. She scheduled a follow-up in 3 days. Within
> 24 hours baby was running a temp of 100.4 and rose to 104 by
> admit to ER locally. UTI identified caused by posterior
> urethra valve, transferred to Seattle Children's Hospital.
> IV antibiotics for four days then surgery to remove the
> valve and another 10 days of IV antifbiotics. Mom
> continues to pump and supplement EBM. No problems with
> breastfeeding in hospital but no support for solving suck
> issues. I am not sure how assertive mom was about
> it---pretty overwhelming medical stuff already!
>
>
>
> Baby is home at 7'3" yesterday (5 weeks old) and just
> maintaining. He spits up the supplement even in small
> amounts and held upright following feeds. He wants to suck
> 'all the time'. Output is meeting minimum standards.
> Tongue is down during nursing now due to mom using a nipple
> shield to help him. Mom can see milk leak out his mouth
> while nursing and she can see him swallowing. No choking or
> gagging or respiratory changes while nursing. Nephrologist
> (spelling?) told mom that babies with these problems don't
> gain easily and if he doesn't begin gaining they will
> recommend a feeding tube. Only exclusively (if you don't
> count the meds he is on) BF baby they've ever seen! They
> have put him on antibiotics 'just in case' and he takes a
> 'salt' medication to help his kidneys.
>
>
>
> Baby continues to slide down the nipple in order to suck,
> tires quickly. Over the weekend I took her a baby scale
> and a Lact-Aid supplementer someone dropped off with
> me...right now we need to help this baby gain a few
> ounces! My gut says it has to be baby's tongue or
> something he can't manage to do with the suck. I don't
> have a lot of experience here and it doesn't look like the
> tongue-ties I have seen a lot of...but not normal either.
> This mom is my daughter's best friend and she nearly lived
> with us during high school years...and now she works with me
> and is like my daughter! So sometimes I question what I am
> seeing too, due to the emotional connection. I would like
> to have her evaluated by someone with more knowledge on this
> but two leading experts kind of glanced at baby in hospital
> (didn't even examine oral structures!) and said everything
> looked fine. And another nearby resource doesn't think she
> can help although she has only talked to mom on phone and
> me. Again mom may not be very asser tive when she talks
> with them....I just keep coming back to his tongue doesn't
> look 'right' to me! Maybe I am nuts! Any ideas or if you
> have worked with a baby with his problems....we are open to
> any ideas! Wish I had taken photos of his mouth this
> weekend...maybe I will try that this week. Mom reports
> today that baby is maintaining weight over weekend but
> gaining. She also says that it appears to her that his
> tongue pulls slightly to the right when he tries to extend
> it. Needless to say we are both looking all the time!
>
>
>
> Thanks!
>
> Michele L. Crockett, IBCLC, LLLL, PCPA
>
>
>
>
>
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