I saw a baby yesterday with a very distinct click.  Quick history.  She was
6 weeks early, is now 11 weeks old. She was small, but had no problems and
came home as a normal newborn.  I saw her in hospital and at home at 4
weeks. No clicking at that time.  Slight corrections in latch were made. 
She has gained above average all along.  The mothers nipples are normal,
regular shaped, pliable, nothing remarkable.  The mother has an abundant
supply.  I visited yesterday on a complaint that the baby has excessive
wind and is quite fussy most of the day.  The mother thought that she was
taking in air with the sucking because of the click.  On my assessment, I
didn't see any air being taken in.  On digital exam, I noticed that the
"bubble" in the baby's palate was very short and that she gagged strongly
when my finger was only about 11/2 cm in her mouth.  Her mom said that she
gags on a dummy, and that she clicks at the breast and on the bottle. The
baby's tongue was bunched up and the suck was disorganized.  We decided
that the gas was probably an oversupply problem, and started a program to
reduce supply.  It seems obvious to me that this little one is bunching her
tongue to protect her gag reflex, and that she is still gaining because of
the mother's oversupply.  I am a little concerned that normalizing the
supply, could compromised her weight gain.  We were able to fix the latch a
couple of times, but after maybe 4-5 sucks, she slipped back into the
clicking.  The mother is working with some suck training and with the
latch, but in the meantime, the baby is doing okay with the clicking.  Will
she outgrow this gag reflex?  Does this sort of disorganized suck also
improve with time??  Should the oversupply be left alone?  Any
comments/suggestions would be welcome.  
TIA  
Merilee
Basel, CH   
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