Guest guest Posted January 21, 2012 Report Share Posted January 21, 2012 , it sounds like that baby is working really hard and the suck/swallow/breathe is not regular or easy. I'd refer to Lynne or Robin for sure! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- From: Fenner Subject: squeeky breastfeederTo: Date: Friday, January 20, 2012, 5:33 PM Hello! I have a question about squeaking while breastfeeding. (permission to post). I am working with a client and new baby 3 weeks old. Mom has lots of milk and fast flow. Baby has posterior tongue tie, released once, CST once to help arms move, relieve cranial asymmetry. Mom had cracked and bleeding nipples prior to frenotomy. Latch improved for about a week. Now mom reports tickly feeling on nipple while nursing, shallow latch. I suggested assessing tongue for a revision, more CST for improved, but continued asymmetry, and sucking on mom/dad's finger to improve sucking pattern (see next). Baby is doing best she can with a fast flow and TT. We talked about how to help her cope and make it not so difficult for her (anti-gravity, express milk ahead, etc). I also noticed squeaking with each swallow at the beginning of the feed and intermittently throughout and after the feeding. She has an irregular suck pattern: 4-5 sucks, pause, tongue thrust, and gums clamp while she breathes. Then it repeats. I was noticing her breathing a lot. I'm not sure if I am fixated on it because something isn't right, or she is just working hard to nurse and gets tired. My question is at what point does it make sense to suggest OT/PT? We have a great team at Children's hospital here. I don't want to over-treat and send them to another provider if this just needs some time to work out. I suggested they consider it after checking out the CST and TT again if the latch still isn't better. I appreciate your wisdom. Fenner, IBCLC Nurture New Life Providing Breastfeeding and Mothering Support Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 Thank you for your suggestions. I re-read Genna's description of laryngomalacia and that is a possibility. The symptoms all match, except it didn't sound like stridor, more squeak with each swallow. I talked to the parents and they are making an appointment with Children's for the respiratory evaluation. The more I think about it, I realize I was focused more on the TT and caught myself trying to make the symptoms fit that. When they just didn't completely, I saw it is more respiratory related, and TT contributing. We decided to wait on the revision to avoid further stress to the baby, plus my concern that releasing the TT could cause more difficulty in the short term. Fortunately, mom has plenty of milk and she is growing well. Fenner, IBCLCNurture New LifeProviding Breastfeeding and Mothering Support Sounds like Laryngomalacia- They also have more trouble controlling suck swallow breathe, and the fast flow also can make it worse. I also find it is worse when the baby is tired. You can read about it in Gennna’s first book. Billowitz, IBCLC Israel From: [mailto: ] On Behalf Of Fenner Sent: Saturday, January 21, 2012 3:34 AMTo: Subject: squeeky breastfeeder Hello! I have a question about squeaking while breastfeeding. (permission to post). I am working with a client and new baby 3 weeks old. Mom has lots of milk and fast flow. Baby has posterior tongue tie, released once, CST once to help arms move, relieve cranial asymmetry. Mom had cracked and bleeding nipples prior to frenotomy. Latch improved for about a week. Now mom reports tickly feeling on nipple while nursing, shallow latch. I suggested assessing tongue for a revision, more CST for improved, but continued asymmetry, and sucking on mom/dad's finger to improve sucking pattern (see next). Baby is doing best she can with a fast flow and TT. We talked about how to help her cope and make it not so difficult for her (anti-gravity, express milk ahead, etc). I also noticed squeaking with each swallow at the beginning of the feed and intermittently throughout and after the feeding. She has an irregular suck pattern: 4-5 sucks, pause, tongue thrust, and gums clamp while she breathes. Then it repeats. I was noticing her breathing a lot. I'm not sure if I am fixated on it because something isn't right, or she is just working hard to nurse and gets tired. My question is at what point does it make sense to suggest OT/PT? We have a great team at Children's hospital here. I don't want to over-treat and send them to another provider if this just needs some time to work out. I suggested they consider it after checking out the CST and TT again if the latch still isn't better. I appreciate your wisdom. Fenner, IBCLCNurture New LifeProviding Breastfeeding and Mothering Support __________ Information from ESET NOD32 Antivirus, version of virus signature database 6813 (20120120) __________The message was checked by ESET NOD32 Antivirus.http://www.eset.com -- Fenner, IBCLC Nurture New Life Providing Breastfeeding and Mothering Support NurtureNewLife@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2012 Report Share Posted January 23, 2012 thanks for letting us know! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: squeeky breastfeederTo: Date: Monday, January 23, 2012, 10:26 AM Thank you for your suggestions. I re-read Genna's description of laryngomalacia and that is a possibility. The symptoms all match, except it didn't sound like stridor, more squeak with each swallow. I talked to the parents and they are making an appointment with Children's for the respiratory evaluation. The more I think about it, I realize I was focused more on the TT and caught myself trying to make the symptoms fit that. When they just didn't completely, I saw it is more respiratory related, and TT contributing. We decided to wait on the revision to avoid further stress to the baby, plus my concern that releasing the TT could cause more difficulty in the short term. Fortunately, mom has plenty of milk and she is growing well. Fenner, IBCLCNurture New LifeProviding Breastfeeding and Mothering Support Sounds like Laryngomalacia- They also have more trouble controlling suck swallow breathe, and the fast flow also can make it worse. I also find it is worse when the baby is tired. You can read about it in Gennna’s first book. Billowitz, IBCLC Israel From: [mailto: ] On Behalf Of Fenner Sent: Saturday, January 21, 2012 3:34 AMTo: Subject: squeeky breastfeeder Hello! I have a question about squeaking while breastfeeding. (permission to post). I am working with a client and new baby 3 weeks old. Mom has lots of milk and fast flow. Baby has posterior tongue tie, released once, CST once to help arms move, relieve cranial asymmetry. Mom had cracked and bleeding nipples prior to frenotomy. Latch improved for about a week. Now mom reports tickly feeling on nipple while nursing, shallow latch. I suggested assessing tongue for a revision, more CST for improved, but continued asymmetry, and sucking on mom/dad's finger to improve sucking pattern (see next). Baby is doing best she can with a fast flow and TT. We talked about how to help her cope and make it not so difficult for her (anti-gravity, express milk ahead, etc). I also noticed squeaking with each swallow at the beginning of the feed and intermittently throughout and after the feeding. She has an irregular suck pattern: 4-5 sucks, pause, tongue thrust, and gums clamp while she breathes. Then it repeats. I was noticing her breathing a lot. I'm not sure if I am fixated on it because something isn't right, or she is just working hard to nurse and gets tired. My question is at what point does it make sense to suggest OT/PT? We have a great team at Children's hospital here. I don't want to over-treat and send them to another provider if this just needs some time to work out. I suggested they consider it after checking out the CST and TT again if the latch still isn't better. I appreciate your wisdom. Fenner, IBCLCNurture New LifeProviding Breastfeeding and Mothering Support __________ Information from ESET NOD32 Antivirus, version of virus signature database 6813 (20120120) __________The message was checked by ESET NOD32 Antivirus.http://www.eset.com -- Fenner, IBCLC Nurture New Life Providing Breastfeeding and Mothering Support NurtureNewLife@... Quote Link to comment Share on other sites More sharing options...
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