One thing I've found helpful is using a floating prone position - anything to help baby stay flexed with room for the chin to extend forward.  Mother can be laid back or on her side with baby coming under her arm.   Lots of suck-training with the thumb can help this.  With reward, of course.  I've seen it take 4 weeks for baby to overcome.  Sometimes lactaid helps.   



-----Original Message-----

From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Laura Spitzfaden

Sent: Thursday, July 17, 2014 9:58 AM

Subject: Baby Possibly Orally Defensive



PTP.



Infant was revised tongue and lip and has healed well.



She was intubated at birth for fluids in her stomach due to polyhydramnios. She experienced stridor for her first night.



Baby has a receding lower gum-line but not as dramatic as some I have seen. She has a pretty high, bubble palate and she is very gaggy.



She does not keep her tongue over her gums when breastfeeding or when sucking on a finger. It still hunches in back. She has been seeing a CST and is going to be going to another and maybe also a pediatric OT for possible oral defensiveness due to the intubation.



Mom is still in a lot of pain from the biting that Baby is doing because her tongue is not over her gums. The usual head extension postioning is not helping but chin tucking helps Mom to have less pain.



I have heard that SLP recommend chin tucking for feeding but I have never seen a case where it made for a less painful latch.



Any ideas?



Laura Spitzfaden, LLLL, IBCLC, APL



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