LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Sharon A Vallone <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 10 Aug 2001 00:38:41 -0400
Content-Type:
text/plain
Parts/Attachments:
text/plain (140 lines)
If possible, have the infant evaluated by a chiropractor who does cranial
work or a craniosacral therapist to determine if there is dysfunctional
temporomandibular movement which could result in changing the diameter
and "roundness" of the mouth (it's ability to open and how wide and round
it opens). The muscles lying under the lips become strained out of their
normal position and effect a pulling or restriction on the lips so
infants often suck their lips in and they are difficult to pull out.  The
lips and the retracted chin are often signs of a change in mandibular
position or altered mechanics of the excursion of the jaw.


On Thu, 9 Aug 2001 16:41:11 -0200 Pamela Morrison IBCLC
<[log in to unmask]> writes:
> Dear All
>
> I've been following the history of the baby who will only feed while
> sleeping, looking for clues!
>
> I am currently working with a seven-week-old baby who seems to be
> very slow
> to learn to breastfeed.  This little boy was referred to me at 15
> days by
> the paediatrician for weight loss.  He was born at 39 weeks, normal
> delivery, no complications, no suctioning, weighing 3000g.  He was
> discharged fully "breastfed" at 3 days.  By 9 days he had become
> dehydrated
> (now 2750g)  and jaundiced, TSB nearly 400, and was readmitted to
> hospital
> for phototherapy, IV fluids followed by formula, and discharged 2
> days
> later.  By 15 days I became involved because he still wasn't
> breastfeeding
> properly.
>
> A BF exam confirmed that mom's nipples were an "easy" shape and
> size, but
> baby's chin receded slightly more than usual, he sucked in his lower
> lip and
> slurped on to the breast, seeming reluctant to take a wide gape, and
> mostly
> tongue-sucked. As you would expect, there was minimal/no milk
> transfer and
> mom's breastmilk supply had been severely compromised. A nipple
> shield did
> not seem to "work" for this baby either.
>
> I suggested what I usually do for low-supply situations - attempt
> breastfeed, top up with EBM, then formula, provided manual pump etc.
>  I also
> suggested bottle-feeding this little one using an ordinary rounded
> teat, to
> "teach" the tongue to come down and forward. Mom was wildly
> successful
> within a short time in returning to exclusive breastmilk-feeding.
> The baby
> was quite difficult to bottle-feed too, being reluctant to open his
> mouth
> too wide, but is now doing fine, aged 7 weeks, and his average daily
> gain
> since I saw him at 15 days has been a massive 48g/day (1.5 oz).
>
> We had a follow-up yesterday to try and get *breastfeeding* itself
> fine-tuned.  The baby's chin has come forward, his tongue stays
> down, his
> palate seems to have flattened out a little, his paediatrician has
> examined
> his mouth, throat, nose and ears and nothing is wrong, mom has a
> great milk
> supply, all the right things.  Yet this little guy remains almost
> impossible
> to *breastfeed*.  He will now latch, still slurps on to the breast,
> reluctant to open the mouth, but then flutters happily and falls
> asleep!
> Breast compression stimulates the let-down, but still he will not
> suck!!
> Mom still maintains there was no suctioning at birth.  He is still
> sometimes
> difficult to bottle-feed too, but obviously she manages it, as
> evidenced by
> the fact that he is really thriving. Her latching technique is very
> good,
> it's difficult to get this little guy to latch deeply on to the
> breast, but
> she does achieve it, and she is sensitive to his tolerance levels,
> stopping
> if he becomes upset.  We spent an hour and a half together yesterday
> so I
> was able to observe all this.
>
> So now, I'm stumped. In similar cases, the baby seems to breastfeed
> really
> well after 2 - 3 weeks once you get the positioning and latching
> techniques
> co-ordinated.  This one is going on too long.  He seems bright,
> normal,
> active, thriving, in every way, but he just wont breastfeed!  Does
> anyone
> have any suggestions?  Barbara, I wish I could refer this baby to
> you!!  In
> the meantime I have suggested that mom continue what she is doing,
> with the
> exception of setting aside 4 - 6 hour periods in the afternoons
> (when the
> baby is more active) where only the breast is offered, to provide
> more
> practice.  However, because I still saw very little milk transfer at
> the
> breast, I've suggested continuing to pump and bottle-feed the EBM
> after
> breastfeeding attempts at other times unles mom is aware of good
> swallowing.
> I still don't think attempting to go cold turkey with this baby
> would work
> and still think that his nutrition needs to be protected.
>
> Sorry so long.   Any thoughts welcome.
>
> Pamela Morrison IBCLC, Zimbabwe
> [log in to unmask]
>
>              ***********************************************
> The LACTNET mailing list is powered by L-Soft's renowned
> LISTSERV(R) list management software together with L-Soft's
> LSMTP(TM)
> mailer for lightning fast mail delivery. For more information, go
> to:
> http://www.lsoft.com/LISTSERV-powered.html

________________________________________________________________
GET INTERNET ACCESS FROM JUNO!
Juno offers FREE or PREMIUM Internet access for less!
Join Juno today!  For your FREE software, visit:
http://dl.www.juno.com/get/tagj.

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html

ATOM RSS1 RSS2