dear jeanne and pamela, et al,

pamela, you are exactly right in your observations. in the BAB this is called
the arching baby, or hypertonic. i have seen a lot of this, actually. they
seem to outgrow this by three months or so, but it is miserable for the mother
in the meantime, depending on the severity. an experienced mother came to me
once, with a baby moderately affected, and she had managed pretty well for
three months! it was only at that point that the growth rate slowed enough to
be a concern.

primips usually wean right away. there are a lot of ideas in the BAB for
dealing with this problem, but it also states, correctly, that extremely
severe cases may need supplementing or feeding with a bottle, because they
truly cannot get on and stay on and nurse well enough to get sufficient
calories.

this is where the cranio-sacral work comes in, which of course, like so many
other things, i first heard about on lactnet. the idea is that this may not be
just an immature nervous system, the usual cause blamed for this, but a
misalignment of the skull bones following a traumatic birth, and that this
therapy can "fix" the problem. that's why i am really urging these parents to
do this. the baby's birth had a number of interesting factors, and the baby
seems to favor one position over another, an indicator of some head/neck pain
or stiffness. (i hope.)

i did try the positional ideas already, which helped slightly, but this baby
is just not there yet. the parents were using the playtex nipple, which of
course is short, so i gave the mother some avent bottles to use, which the
baby seemed to accept pretty well, after some pushing down on the tongue
exercises. the idea there is to get the baby to open the mouth more.

i told the mother to toss out the pacifier, use the avent bottle, make open
mouth and tongue sticking out faces at the baby, do the tongue exercises, and
consider a rebirthing bath, the cranio-sacral therapy, and have constant skin
to skin, including letting the baby smell, lick, and nuzzle the breast without
attempting latch.

she has a whole bunch of problems with incipient mastitis, etc., so you can
well imagine this was the longest house call in the history of lactation (not
really, but it seemed like it). she said something wonderful, however, when i
arrived and she began her history. she said, i am starting with a clean slate
with you, all the advice i got previously has not worked, so i am just
ignoring all of it and starting over.

the baby is not aversive to the breast, wants to nurse, etc., so i have faith
it can happen. of course i have faith! just waiting for the miracle.

carol brussel IBCLC

ps i have a file in which i have put the BAB arching baby stuff, so if anyone
doesn't have it and wants to read it, just email me and i can send it easily