Hello fellow Lactnetters!

Have a question.  Hoping someone out there may have had experience with this
or can point me in the direction of some references or research.

A mom I've been working with since January has actually asked me if I can
find out some more info concerning her baby, now 5 1/2 mos. old.  An
important piece of this puzzle is that this is her 2nd BF baby and she
successfully BF her first child til he was 16 or 17 mos.

Mom had healthy, uncomplicated pregnancy and unmedicated, uncomplicated
birth.  Baby full term and weighed 7lb. 15oz. at birth.  Baby had gained
1lb. 3oz. at 2 week check.  It wasn't until 2 mo. check at ped. that a
problem was discovered, a gain of only 8 oz.

A suck assessment revealed a very non-rhythmical, uncoordinated (or
disorganized, whatever you want to call it) suck.  The baby, at times will
curl her tongue up and air can be heard wooshing in at the corners of her
mouth during feeding.  Sometimes, she's got it together, but only for a few
sucks, then she's back to curling the tongue up or arching up in back,
interspersed with clamping down occassionally.  It is very weird. Never have
seen a suck quite like this before.  The poor mom has been through a
lot-very dedicated to BF and is working full-time as well.

At the present time, what seems to be working, is pumping several times a
day and, when mom is with baby, she Bf with SNS with EBM.  At daycare, baby
takes mostly EBM with a Munchkin nipple.  Only has one bottle ABM at
daycare.  This was at my suggestion, due to mom getting very stressed at
ability to produce enough by pumping for baby in her absence and deal with a
2 yr. old demanding her time as well.  Felt like it was better than giving
up BF all together - mom agreed.

The last time I talked to mom, about 10 days ago, she stated that baby's
sucking was SLOWLY improving, that she still makes the air-wooshing sound
when BF but not at much.  It is much less noticable during night feeds.  She
still uses SNS for all BF's and baby is doing about the same at daycare.
The Munchkin nipple seemed to work better for her, causing less problem when
she returns to breast. Interesting. ;-)

This is NOT a neuro baby!  She is developing quite normally and a little
advanced in some areas, according to what mom reports from Ped.  Her weight
gain is and has been good ever since she began using SNS at every BF.  Gains
approx. 8 oz. a week.

The questions are:  What could have caused this sucking problem?
                    What is the long term outcome?
                    What should she be looking at as far as lenght of time
to                     resolve?
                    Would bottle feeds at daycare prolong the time it takes
to                     resolve?

This mom has seen 3 LC's, 3 LLLL and one Occupational Therapist as well as
switching peds.  She was doing suck training taught by LLLL, then exercised
taught by OT and quit over busy holiday season.  Has noticed no difference
in feeds since discont. of exercises and felt, why bother?

If any of you have any ideas or info for this mom, she would GREATLY
appreciate it.  She would be willing to look up research article if she
knows where to start.  She is a biochemist at the university here, so has
access.  I can't find anymore info. Had referred her to a friend of mine who
had the last THREE of her five babies with this same sort of problem for no
obvious reasons to provide support and hope that they turn out fine in the end.

You can feel free to post answers to the group or email me privately.  I
think we could all benefit from anyone else's expereince.

A BIG TIA!!

Melody Engberg, IBCLC, LLLL
Memphis, TN