Hi Mary

My husband is an ENT surgeon so I have asked him for a few comments.  Hope
they help.


>Please lactnetters I need some help with this one. Doesn't any one out
>there have experience with a baby with a paralyzed vocal cord, What might
>be the effect on his ability to nurse?

Depends on whether the palsy is acquired or baby was born with it.  Further,
if there is any neurological deficit, in addition to the vocal cord palsy,
that complicates the picture.

If the paralysis is isolated & congenital, breastfeeding should be no
problem.  With other neurological problems/acquired palsy, the baby's doctor
will be aiming to bypass the throat and get the feed directly to the
stomach.  Some of these children end up being fed via gastrostomy tube
directly into their stomach.

> Can he create a suction.?   yes

>Will he be prone to aspirate?   yes.  But as we all know, aspirating
breastmilk is far better than aspirating formula.

It is best to breastfeed with the affected (left) side *UP* ie. baby laying
on right side for right side breastfeeding and perhaps underarm hold for
left side breastfeeding.  Avoid flooding the baby's mouth - perhaps take the
baby off if Mum has an overactive/fast letdown etc.  Mother should be very
conscious of baby's behaviour during breastfeeding and remove baby if he/she
starts coughing.

>How does the vocal cord affect suck swallow? The doctor is proposing gavage
feeding for who knows how long

It has no great effect on suck, as suck is generated in the mouth.  Swallow
is affected as there is an inability to close off the larynx completely to
prevent aspiration.  There are other effects, but its getting late & I'm too
tired to type his dissertation!!!

Good luck
regards

Trudi
:-) 8  :-) 8  :- ) 8  :-) 8  :-) 8  :-) 8  :-) 8  :-) 8  :-) 8
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Trudi Szallasi  RN BN
NMAA Breastfeeding Counsellor
NMAA representative on BFHI Qld Committee
BCS Consultant
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