In a message dated 6/10/2006 7:00:32 A.M. Eastern Daylight Time,
[log in to unmask] writes:
My problem is when bf seems fine, but the baby is not.
Then I need a definite answer - is this a medical, non bf related problem,
and
supplementation will just mess up bf, or - is this an intake problem, maybe
even
caused by a medical problem, which needs to be investigated, but I also need
to
supplement in the meantime.
Dear Friends:
This question has so many different answers.
I assume the milk is fine, if bf is fine but the baby is not.
Then my assessment goes into baby stuff: anatomy, vital signs, listening
to the throat with a tiny stethescope. Is baby's cardiorespiratory system
alright? Is baby truly swallowing fully with each suck? Is the symmetry and
range of motion of the oral structures within normal limits? What else is this
baby doing? What is the baby GI tract doing? Is the baby in pain, and if so,
when? What is baby's chosen body posture during the feed? What infant sounds
are noticed during the feed? Is the gape/suck/seal/ intact?
Gosh, there are so many different roads to travel here. Cadwell,
Turner-Maffei et al. have a lovely book Maternal-Infant Assessment that organizes
all the different parts of assessment. And then there is Wolf and Glass's
classic, Feeding and Swallowing Disorders in Infancy.
We've seen on LACTNET about the case histories where babies have some
immune system variations that require more extensive investigation. I am
thinking about a physician who posted here a few years ago, and her baby was
diagnosed until endoscopy with some unusual enzyme or allergic
manifestation...........sorry, but I can't remember.
I am looking forward to all the responses to this terrific question.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, RLC, CCE
craniosacral therapy practitioner
Faculty, Lactation Division Maternal-Infant Program, Union Institute
Film Reviews Editor, JHL
www.breastfeedingalwaysbest.com
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