I'm assisting a mother of a prem to breastfeed.  Baby was born at 27K
weighing 820g and was intubated for 61 days.  She's now 111 days old and is
having 3 breastfeeds per day.  Mother has an abundant milk supply :-)

This baby has a very high narrow palate - we've usually attributed this to
intubation, but my fading memory tells me somewhere it heard that it's the
prematurity and less-than-ideal environment (ie. out of uterus) that causes
this.  Is this correct?  Doesn't really matter in the long run for this
little one though, because that's what she's got.

Her weight stalled last week (10g loss in two days) so I was asked to
review her (yes, I know, it took a while!).  We worked on improving latch
and feeding more milk from the end of the pumping than the beginning (for
the tube feeds) and baby subsequently gained 60g in the next two days and
stools improved in colour and smell too.  Mother doesn't have sore nipples.

the mother needs to hold the baby firmly at the breast and hold the breast
shaped throughout the feed for the baby to not slip back and just suckle on
the nipple.  Neither action am I happy with, but that is what is necessary.
 Do you think the palate is what is causing the 'stay-on' problem - having
problems achieving a negative pressure.  I know that 'habit' is also a factor.

Should I anticipate more problems with this palate - particularly as she
goes onto more breastfeeds?  Please share your experience with me.

Thanks
Denise

****************************************************
Denise Fisher, BN, RN, EM, IBCLC
BreastEd Online Lactation Studies Program
http://www.BreastED.com.au
mailto:[log in to unmask]
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