PTP:

I've been working with a family for about a month, baby is 5 weeks old.  Baby has a tongue tie that should get revised next week.  In the meantime mom is managing the snacking and low transfer with compressions, pumping and bottle supplementation.  However, in the last 2 weeks baby has been exhibiting a new behavior, which of course she hasn't demonstrated to me (we've tried to get me there to watch and baby is insistent that she perform perfectly for the audience).  

This is what mom says "Today started off ok but quickly fell apart with hours of "snacking" followed by blood-curdling screaming when taken off the breast and we were unable to get her to sleep. Latch was really poor and she would get fussy when I tried to make it better.  I gave her an ounce of breast milk around 3:30 out of desperation and nipple soreness, then continued to allow the snacking.  By 6:00 my nerves were completely shot--at that time she was on the breast for no more than a minute, fell asleep and I couldn't wake her, until of course I tried to put her down and screaming started again.  We ended up giving her 2 oz more of breast milk, she screamed awhile longer, and then finally fell asleep about 7:30.  Diapers have been consistently wet and poopy.  She doesn't have a fever that I can tell.  I don't know if we're dealing with gas or what, but this is crazy."

I feel like most of this is normal, tongue tied baby stuff.  But, I'm a little concerned about the screaming.  Could it be reflux? Baby doesn't spit up a lot and is gaining normally.  Any thoughts on clinical supervision? Anything I'm missing? Baby is a snuggler and mom doesn't have a lot of support in the home (dad is back to work) should I recommend post partum care?  I'm feeling just a bit baffled.

Thanks in advance.

Lea Rivera Todaro
Brooklyn, NY

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