Could this be thrush? <unusual amount of white coating on her tongue>
Gail
Gail S. Hertz, MD, IBCLC
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----- Original Message -----
From: "Riva Weissfish" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, October 15, 2010 3:55 AM
Subject: sudden breast refusal at 5 weeks
I saw an alert, happy, cooing 8 week old baby last night who has me stumped.
Mom complained that since 3 weeks ago baby adamantly refuses the breast
except when she is sleepy. Baby is screaming and arching and giving up
meals. I had seen baby at one week old and observed what looked like good
breastfeeding. Baby was getting satisfied and gaining weight ( This mother
was staying in the facility where I work and ask me to take a look, just to
be sure)
Last night, I saw a beautiful latch with much swallowing and all seemed
fine. Mom was amazed, saying that she never eats like that. After a bit of
talking she offered the baby the other side. Baby started to take a sip or
two and broke into incredible scream turning almost purple and kicking and
arching. The mother was gratified that at least I understood what she was
talking about. After that could not get this baby relatched in any
position. Calmed baby down and tried to have self attach from on top of mom.
She was calm and poked around a bit but could not get a latch. Tried again
in a more upright position on the other side- same kicking refusal. When I
checked her suck she played around with her tongue, would create no
suction, as if she had no idea what to do. Mom has tried: different
positions, bottle feeding , having her SIL breastfeed her all meeting with
the same violent reaction. No change in diet, meds, soap, detergent, perfume
etc. There is no way to predict when this will happen. Sometimes she will
start a meal and then pull away, sometimes she won't start though she is
starving, and sometimes she will quietly nurse. Mom nursed previous 2
children 6-12 months. Calm and confident, though this baby is a real
challenge. Was checked by pediatrician on the previous evening who found no
problem. Baby does have a high and very narrow palate and unusual amount of
white coating on her tongue. Tongue is flat when she cries, BUT until 3
weeks ago she was doing quite well –I couldn't blame her tt- it seemed too
simplistic to me. Seems a bit low tone.
I suggested the following and told the mom I would keep thinking – ask for
your help.
Bathe with baby, bf with lights off, CST, cup feed, anticipate and wake baby
for feeds(ie feed in sleep)
Has anyone seen this kind of situation? ( I have had a couple of clients
with breast refusal but it was just after birth or every feed or baby would
at least take a bottle- she is not refusing the breast she is refusing to
eat after a period of success.)
I would greatly appreciate your input!!
Thanks for listening , waiting for your wise words,
Riva Weissfish BA,CCE, IBCLC
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