Mary,

Has baby had any cranio-sacral therapy done before or after the revision?
On May 6, 2014 4:08 PM, "Mary Jozwiak BS, IBCLC, RLC" <[log in to unmask]>
wrote:

> Hello wise ones,
>
> I am currently working with a lovely mother and baby dyad (I have
> permission to post) who presented with OER, tight labial frenulum,
> posterior tongue tie and seriously damaged nipples in mom. Babe is gaining
> like gangbusters.
>
> First visit, we worked on the latch. Baby was clicking and biting. Had a
> difficult birth with suction device used on head during birth with small
> hematoma on back of head, deep oral suctioning due to meconium staining
> resulting in some clamping during feeding. Saw some baby protecting his
> airway and mild oral aversion during first visit. Takes breast with no
> aversion, though. But, baby gags easily.
>
> Latch was corrected with referral to DDS who does great TT and Labial Fren
> laser work. Parents were a bit overwhelmed and not on board right away with
> seeing DDS for frenecomies. After several phone calls, babe had lip
> correction done. Second visit, feeding somewhat better, but the tongue was
> still a problem. DDS contacted me and we both agreed the tongue needed
> laser frenectomy. This was done last week.  DDS contacted me to see mom
> again to help with latch with new tongue skills.
>
> Mom is still in pain, baby is still clicking some. I will see her
> tomorrow, looking for thrush, considering shield, as mom was considering
> taking baby off of breast completely for a week to let nipples heal (she's
> in pain) and I felt the shield may help with less damage to the baby's
> learning new muscle memory than a week or even a few days of bottle use. It
> may help him keep his tongue in proper position, depending on what I see
> and feel tomorrow when I see him.
>
> OER has been treated, greatly fewer green stools (almost none) and
> seemingly less tummy trouble. Despite OER, (it can be heard easily, she
> ejects within 3-6 seconds of latch, frequent ejections during each feed,
> large number of diapers and great weight gain) mom does NOT spray, dribble
> or leak most of the time when attempts are made to remove baby from breast
> to allow first ejection to flow into burp rag. (Babe was displaying
> foremilk overload, it appeared at first visit. That seems to have resolved
> at this time. Mom intuitively started very flexible "using one breast as
> often as he likes for a few hours" method independent of any instruction.
> Good instincts in mom. She says this has helped, and baby is gaining well.
> The breast usage is very flexible, NO rigid "block feeding" of old being
> used.)
>
> I think Mom may be close to giving up, despite baby doing fairly well. She
> is still dreading feedings several times a day.
>
> Suggestion was made from me for cranial sacral adjustment, but mom is on
> the edge of burn out from many suggestions from not just myself but others.
>
> I will see her tomorrow to examine baby, witness and help with latch,
> assess for thrush etc.
>
> Baby is now 5 weeks old, very engaging, cooing, smiling, seems happy and
> well fed. Mom is in intermittent serious pain, latch is great while I am
> there, but she sees squashed nipple at times after feeding and has "burning
> pain for 2 hours after showering." On some days the nipples are not painful
> at all. Very frustrating for all. It doesn't seem like classic thrush to me.
>
> I'm thinking Baby hasn't figured out how to properly use his tongue yet,
> but has some odd habits from 4 weeks with tongue fairly glued to the floor
> of his mouth, now those muscles are being used ON her nipple improperly.
> (Mom was given finger/tongue exercises, but baby still gags easily when
> fingers are placed in his mouth, last I checked with her.)
>
> I hope I'm not missing anything. Tough case. I see a lot of TT and TLF,
> most resolve after lasering fairly well.
>
> Thank you all in advance,
>
> Mary Jozwiak, IBCLC, RLC
> Board Certified Lactation Consultant, Post Partum Doula
> Birthwaysinc.
>
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