I would support the idea of checking out a chiropractor or cranial sacral
practitioner for this infant, altho I urge you to be sure this is a person
who has had a lot of exper. with infants.  Physical therapists also work
with gentle exercises to help these babies regain range of motion.
Torticollis can present only mild problems or it can profoundly affect
breastfeeding.  If the baby has difficulty supporting normal movement, the
partial paralysis/muscle spasms can impact oral function and ability to
latch deeply.  Close observation of how the baby moves can help you decide
if there are positioning tricks you could employ which might make it easier
for the baby.  Does the baby have better function on one side than the
other? etc.

I want to make an observation about recovering milk supply when it has not
been well-protected during the original lactogenesis II stage.  First of
all, I think it borders on malpractice to see an non-nursing or weakly
nursing infant with an obvious physical condition and fail to provide a
mother with information and equip. to protect the milk supply.  You cannot
gamble on sending a baby like that home just hoping for the best without
creating a risk of impaired production that can't be recovered.  Mike
Woolridge calls that an acquired low supply, and it results from prolonged
engorgement (over 48 hrs) which can cause pressure involution and partial
weaning which may not be recoverable.

I have had many, many cases where I've become involved at 7-14 days
postpartum, and mother has a poorly feeding infant and has not been pumping
or hand expressing aggressively.  In some of those cases, I've started
hospt. grade pumps, herbs, metaclopramide, deep breast compression, freq.
nursing with or w/out shields to get baby to breast, etc. etc. and never
been able to recover a full supply.  Many times the milk comes back nicely,
but many times it doesn't.  I don't know why, because I've done the same
things and so have the mothers.  I've come to suspect that there are women
who are very sensitive to down-regulation in the first month of the baby's
life, and they are going to have impaired lactation capacity if they aren't
fully stimulated from the outset.

I agree with those who have written to decry the hospt. LCs telling mom it
isn't worth trying.  These LCs should try to do damage control for what was
essentially an iatrogenic situation, and they should learn never to let that
happen again.  That is what watching outcomes is all about.  However, I do
want to verify their impression that full lactational performance for that
baby may or may not be recoverable.  This is why it is so important to
understand how important it is to commit to protecting the milk supply when
baby's capacity to nurse normally is suspect.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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