Julie writes:

Saw 1st  cranial osteopath at 10 weeks ish who was certain he was refluxing 
but him  symptoms could not be treated until reflux was managed by 
medication and weeks  later saw a chiropractor that said the same saw a different 
cranial not last  week, week before who has treated Harry 4 times and says he 
is not 'typical'  reflux he couldn't feel that anything was tighter/smaller 
than usual and that  harry perhaps has an intolerance ...
~~~
Julie, and all,
WOW, there is a lot going on in that email. It shows just how much families 
 are dealing with these days. A few things stood out, but may or may not be 
 helpful:
 
~ This is the first time I've ever heard a CST/osteopath say they couldn't  
help a baby who wasn't already being helped by medication. The CST here 
works  with babies who are miserable on the meds, as well as "ok" or at least  
better,  on the meds but parents want to try to address the underlying  
issue and perhaps get them off the meds, etc.  I've seen this work many but  not 
all times, depending on other confounding factors.
~ There are other medications other than ranitidine, that seem to work  
better but may have the same side effects as the first. 
~ I've never heard of using gaviscon but that may be a local  difference
~ I believe new standards by IATP (International  Affiliation of Tongue-tie 
Professionals)  suggest that all  babies who have frenulums released should 
have parents who follow up with the  post-revision stretching to try to 
keep the new range and not lead to needing a  revision ( with extreme weakness, 
sometimes it's unavoidable, but even then it  might help)
~ Reflux and tongue-tie often go together, for some reason, like stars in a 
 constellation that show up together
~ Babies who are post-release often have issues with coordination of the  
"new" tongue, with power and with stamina. This can look like overactive  
letdown, but is sometimes actually just an inability to cope with even normal  
flow. Has this baby been getting sprayed in the face, or is there tons of 
milk  dripping down the mom's breast when he pulls away, or does the flow just 
wait  til he starts again? Doing pre and post weights can help one figure 
out whether  a baby is choking because it's either "nurse or drown" with a 
speedy or forceful  letdown of a large amount of milk, OR there is a normal or 
even small amount of  milk being transferred, but they still are choking 
and stressed out
~ A wise LC I know ( hi KL) sometimes suggests eliminating all the top  
potential allergens ( please feel free to jump in with timing and other  info) 
and this might work for a baby who is SO miserable, maybe this LC can  
comment on whether this might work for this family, who would probably like to  
see relief for their little one and themselves, like uh, yesterday
~ I don't know if this baby is able to tolerate tummy time, even lying on  
mom's stomach or dad's stomach while they recline, is helpful, or laying 
face  down on the couch while someone says or does something interesting 
nearby, to  help them look up and around and build trunk strength. This can help 
reflux  too, if not now then in the upcoming months
~ it wasn't mentioned, but does this baby make any squeaky noises (  
laryngomalacia) because often that goes with reflux and tongue tie as well, and  
can make it more challenging to coordinate milk flow with swallowing and  
breathing. Sitting more upright for breastfeeding, breastfeeding with mom lying 
 down on her back or really really reclined can help sometimes, or the flat 
 hand technique or brief pumping with an eye toward weaning off  that,  if 
there really is a powerful flow to deal with

Well that's enough to make one's eyes glaze over. Sometimes there  are so 
many things going on, it's like teasing everything out slowly and  painfully. 
 It must be a real challenge to parent and love a baby who needs  so much 
and is so unhappy! Honestly it is not easy being the support person of a  
family with this level of need either. We're here for you, Julie.
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA
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