Arnold-Chiari malformation happens when parts of the cerebellum and/or 
brainstem is pushed out of the foramen magnum and into the spinal canal, 
usually due to reduced space in the base of the skull. It can cause 
hydrocephalus, by blocking the normal flow of cerebral spinal fluid.

It sounds like something might have happened during the surgery to place 
the shunt that irritated the baby's brain. The shunt might have also 
failed (shunts placed in infants under one have a high failure rate) and 
may be putting pressure on the baby's brain again. Do the baby's eyes 
look strange (does he look down all the time?). If so, this could be a 
sign of high pressure in the skull.

After ruling out a need for a replacement shunt, mom could gently let 
her baby lick and nuzzle the breast until he recovers some of his 
reflexes. Therapy is helpful too, stimulation that can help the brain 
recover if it has been injured during the surgery.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com


On 9/19/2011 7:01 PM, Maya Bolman wrote:
> I got a request for help from lactation consultant and pediatrician from Moscow, Russia. Mother gave a permission to post. They are unable to find any information in Russian and cannot get help anywhere. I do not have any experience working with babies with this condition.
> This baby is 7 month old and was born with hydrocephalus (diagnosed with Arnold–Chiari malformation).  It is 3 rd baby for this mother and she breastfed him for 6 months. He had a surgery done where the shunt was placed. After this surgery he lost sucking and swalowing reflexes as well as gagging reflex. He has a tracheostomy and a feeding tube. He is biting his fingers but cannot even swallow saliva. He doesn't suck on pacifier either.
> Mother is expressing milk and is wondering if she can get baby back to breastfeed or even if it is possible for him to get back the reflexes. If anyone has any tips or suggestions, she would really appreciate them. I will translate into Russian for her.
>
> Thanks,
>
> Maya Bolman RN, IBCLC
>
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