Baby may also have a microcleft in the soft palate that is not visible and needs to be checked by other means, such as a swallow study.
Jean Macomber, RN, IBCLC
Jacksonville, FL, USA
Date: Sat, 16 May 2009 11:30:24 -0600
From: Arie B-C <[log in to unmask]>
Subject: Newborn choking at the end of a feed
Permission to post:
I am working with a 3rd time mom. She has not yet had a successful bf'ing
experience, despite support.
Baby is 4 days old, born @ 38 weeks by scheduled c-section. I've seen her
once, but the baby did not nurse during the visit (bad timing).
Baby shows signs of prematurity, is sleepy, has trouble maintaining temp,
etc. Plenty of wet & poopy diapers, bf'ing is going relatively smoothly.
Mom is wondering about: " baby randomly chokes while nursing. Not
necessarily during letdown, but more often towards the end of a feed." Her
other comments, in response to my questions, are:
-"Def not gagging. She doesn't spit up while it happens. She coughs, and
then makes high pitched squeakingnoises on and off for about 30 seconds"
-"She doesn't CRY afterwards, but yeah, she's gone pretty blue from it. The
squeaks are on inhale, so I'm guessing she's attempting to protect her
airway"
Thoughts, ideas??
--
Arie Brentnall-Compton
780.777.9525
www.tadpoles.ca
Co-owner, Tadpoles & Butterflies; Breastfeeding & Babywearing Educator
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------------------------------
Date: Sat, 16 May 2009 15:25:22 -0400
From: Carolyn Schindewolf <[log in to unmask]>
Subject: Re: Newborn choking at the end of a feed
Since it's at the end of the feed, maybe baby is falling asleep and chokes
on the bolus that's in her mouth. Carolyn Schindewolf, IBCLC
----- Original Message -----
From: "Arie B-C" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, May 16, 2009 1:30 PM
Subject: Newborn choking at the end of a feed
> Permission to post:
>
> I am working with a 3rd time mom. She has not yet had a successful bf'ing
> experience, despite support.
> Baby is 4 days old, born @ 38 weeks by scheduled c-section. I've seen her
> once, but the baby did not nurse during the visit (bad timing).
> Baby shows signs of prematurity, is sleepy, has trouble maintaining temp,
> etc. Plenty of wet & poopy diapers, bf'ing is going relatively smoothly.
> Mom is wondering about: " baby randomly chokes while nursing. Not
> necessarily during letdown, but more often towards the end of a feed."
> Her
> other comments, in response to my questions, are:
> -"Def not gagging. She doesn't spit up while it happens. She coughs, and
> then makes high pitched squeakingnoises on and off for about 30 seconds"
> -"She doesn't CRY afterwards, but yeah, she's gone pretty blue from it.
> The
> squeaks are on inhale, so I'm guessing she's attempting to protect her
> airway"
>
> Thoughts, ideas??
>
>
>
>
>
> --
> Arie Brentnall-Compton
> 780.777.9525
> www.tadpoles.ca
> Co-owner, Tadpoles & Butterflies; Breastfeeding & Babywearing Educator
>
***********************************************
------------------------------
Date: Sat, 16 May 2009 16:44:08 -0400
From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Newborn choking at the end of a feed
The squeaking is called stridor. Two possibilities: either the baby has
not yet got the timing right for coordinating swallowing and breathing,
and fatigues through the feed, until she misses a swallow and draws milk
down to the level of the vocal folds (this would cause stridor as the
folds snap shut to try to keep milk out while the baby is trying to
breathe in). Getting milk to the level of the vocal folds is called
penetration. Usually the stridor of penetration is very brief (2-3 seconds).
Another possibility is that the baby has a respiratory anomaly, one that
narrows the airway. This causes stridor, often during feedings because
babies need to breathe harder during feeding to get enough oxygen to do
the work involved in feeding. The greater effort of breathing puts more
stress on the unstable airway, which narrows more due to the pressures.
The stridor from respiratory issues like laryngomalacia or
tracheomalacia usually lasts longer than that from penetration.
In either case, short very frequent feedings with baby prone and mom
reclined may help the baby get more food with less stress.
Catherine Watson Genna, IBCLC
***********************************************
End of LACTNET Digest - 15 May 2009 to 16 May 2009 - Special issue (#2009-527)
******************************************************************************
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