Erika

Unless the lips can "seal" around an object (breast tissue or teat of 
a bottle) then there can be no suction.  My hunch would be a labial 
tie (hence the U-shaped upper lip which cannot seal...?) or a cleft 
palate.  However, before rushing to clip anything, could the mother 
not create a seal - thus facilitating suction - by ensuring that the 
breast tissue fills the space of the u-shaped upper lip - as we would 
teach to facilitate breastfeeding a baby with a cleft lip?  This 
would be so much easier using a breast, rather than either a bottle 
or a finger.  It might include:
    * good support of the breast with cupped fingers underneath,
    * latching to ensure that the nipple stimulated the palate with 
the thumb dug in to point the nipple upwards,
    * then _releasing the thumb_ so that the loosened breast tissue 
above the baby's mouth is very soft to fill the U-shaped space
    * and then holding the baby in very close so that the nose nearly 
touches the breast and the chin is _well_ dug in underneath, and finally
    * "pouring" the breast into the mouth throughout the nursing to 
maintain the seal and make "sucking" as easy for the baby as possible.

Pamela Morrison IBCLC
Rustington, England
---------------------
Date: Tue, 12 Jun 2012 21:55:56 -0600
From: Erika Lance <[log in to unmask]>
Subject: No seal

Permission to post. I saw a 4 week baby. EBM feed baby. There is obviously
a posterior tongue tie but I have never seen a baby have no seal... at all!
This baby has a beautiful upside down U shape upper lip. Hopefully, that
makes sense and the upper lip won't even touch my finger when I did a suck
assessment. He refuses a bottle and mom latches him on pretty deep and it
"appears" that he is latched to the breast but after one-two sucks he
breaks the weak suction. He repeatedly pops off. He is gaining weight like
a weed with mom's over flow of milk. I have never seen a posterior tie not
compensate and use the upper lip. He doesn't use the lips or the tongue.
Any thoughts of what to do for this baby? I am afraid that the frenectomy
won't help necessarily the absence of any attempt to hold anything in his
mouth. Thoughts??


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