Guest guest Posted February 20, 2012 Report Share Posted February 20, 2012 Well I had a visit last week. Yeah. But now I need some help from so more experienced LC's. PTP This infant did not nurse well from the start lost 12% of body weight so the doctors ordered supplementing. Mom began pumping and bottle feeding expressed breastmilk if she didn't have enough she would give some formula. Baby is now two weeks old mom has been doing a little breastfeeding but having trouble latching infant keeping him latched. So they gave me a call. Right away I noticed infant looked off. As I assessed him further I noticed he had a lot of facial asymmetry. Where his right cheek was nice and round his left cheek was flat. I explained this could be causing a lot of his sucking problem. Infant seems to tire out at the breast. Infant gained 2 oz but feeding lasted over an hour and he had to be stimulated and reawakened alot. I encouraged mom to start breastfeeding more often and start to back off supplement as he started feeding better. I also encouraged her to get him treated by a chiropractor or craniosacral therapist and explained this could help improve his suck. Mom seemed a little overwhelmed. Today I got an email from the grandma who was present at the visit and she stated they were very concerned about the asymmetry and what the diagnosis was. I explained I wasn't qualified to make a diagnosis but he should be seen again by his pediatricain and maybe refferred to a specialist. Infant also has trouble feeding from the bottle. If you ladies had more info on what could help imporove the asymmetry and help his suck or if you can explain to me exactly how a chiropractor or craniosacral therapist could help. Since my practice is so new and small I have not had the opportunity to work with these healthcare professionals. Thanks in advance for you assistance. I have already learned so much from you ladies. Karman Romero RN, BSN, IBCLC www.babysbreaststart.com babysbreaststart@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2012 Report Share Posted February 20, 2012 I would find out a history of the labor and the 2nd stage. I think your instincts are right about chiropractic. I would do the same thing. Maybe offer to do a co-visit with the chiropractor? My moms really like that and feel that they are supported. Poor thing Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA== We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/ To: Sent: Sunday, February 19, 2012 9:53 PM Subject: facial asymmetry Well I had a visit last week. Yeah. But now I need some help from so more experienced LC's. PTP This infant did not nurse well from the start lost 12% of body weight so the doctors ordered supplementing. Mom began pumping and bottle feeding expressed breastmilk if she didn't have enough she would give some formula. Baby is now two weeks old mom has been doing a little breastfeeding but having trouble latching infant keeping him latched. So they gave me a call. Right away I noticed infant looked off. As I assessed him further I noticed he had a lot of facial asymmetry. Where his right cheek was nice and round his left cheek was flat. I explained this could be causing a lot of his sucking problem. Infant seems to tire out at the breast. Infant gained 2 oz but feeding lasted over an hour and he had to be stimulated and reawakened alot. I encouraged mom to start breastfeeding more often and start to back off supplement as he started feeding better. I also encouraged her to get him treated by a chiropractor or craniosacral therapist and explained this could help improve his suck. Mom seemed a little overwhelmed. Today I got an email from the grandma who was present at the visit and she stated they were very concerned about the asymmetry and what the diagnosis was. I explained I wasn't qualified to make a diagnosis but he should be seen again by his pediatricain and maybe refferred to a specialist. Infant also has trouble feeding from the bottle. If you ladies had more info on what could help imporove the asymmetry and help his suck or if you can explain to me exactly how a chiropractor or craniosacral therapist could help. Since my practice is so new and small I have not had the opportunity to work with these healthcare professionals. Thanks in advance for you assistance. I have already learned so much from you ladies. Karman Romero RN, BSN, IBCLC www.babysbreaststart.com babysbreaststart@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2012 Report Share Posted February 20, 2012 Hello, Karman. Pediatricians really don't get it when it comes to physical asymmetries. They'll send the baby off for x-rays and if the bones aren't out of line by a certain percentage, they'll just say he's fine. Had a baby in here last month with a flattened head. I recommended CST, but parents went to ped instead. Ped sent them off to a specialist who said the baby's head is "only off by 5 ml and anything less than 8mm is considered normal." Yeah, right! So ped has no answer about why baby can't suck. Mom won't go to CST because ped says it isn't necessary, but then keeps calling me about why can't baby breastfeed yet?? Grrrr. Dee Kassing Well I had a visit last week. Yeah. But now I need some help from so more experienced LC's. PTP This infant did not nurse well from the start lost 12% of body weight so the doctors ordered supplementing. Mom began pumping and bottle feeding expressed breastmilk if she didn't have enough she would give some formula. Baby is now two weeks old mom has been doing a little breastfeeding but having trouble latching infant keeping him latched. So they gave me a call. Right away I noticed infant looked off. As I assessed him further I noticed he had a lot of facial asymmetry. Where his right cheek was nice and round his left cheek was flat. I explained this could be causing a lot of his sucking problem. Infant seems to tire out at the breast. Infant gained 2 oz but feeding lasted over an hour and he had to be stimulated and reawakened alot. I encouraged mom to start breastfeeding more often and start to back off supplement as he started feeding better. I also encouraged her to get him treated by a chiropractor or craniosacral therapist and explained this could help improve his suck. Mom seemed a little overwhelmed. Today I got an email from the grandma who was present at the visit and she stated they were very concerned about the asymmetry and what the diagnosis was. I explained I wasn't qualified to make a diagnosis but he should be seen again by his pediatricain and maybe refferred to a specialist. Infant also has trouble feeding from the bottle. If you ladies had more info on what could help imporove the asymmetry and help his suck or if you can explain to me exactly how a chiropractor or craniosacral therapist could help. Since my practice is so new and small I have not had the opportunity to work with these healthcare professionals. Thanks in advance for you assistance. I have already learned so much from you ladies.Karman Romero RN, BSN, IBCLCwww.babysbreaststart.combabysbreaststart@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2012 Report Share Posted February 20, 2012 Yes, it does seem useful to encourage getting some second opinions from a chiropractor versed in baby issues, or a CST (in our area, there are a couple of licensed speech-language pathologists (SLPs) with CST as one of the tools in their kits, and sometimes it is reassuring to mothers that the practitioner is also a more recognized-by-insurance speciality). The baby is very new, and you did say that the mother seemed a little overwhelmed. Sympathize that it's difficult to see your child having some initial difficulty with something. And reinforce that if a baby is still gaining strength, symmetry, patience, etc. that breastfeeding is the best oral exercise that we could devise -- it's vigorous, balanced, and babies want to do it. I had a CST tell me that it's great for helping pop things back into alignment. So even if the baby isn't doing championship breastfeeding yet, she needs to see the value in what they are doing together. Getting the baby bigger and stronger is only going to help. So giving the baby plenty of breastfeeding sessions, but keeping them very focused via lots of baby stimulation, compression, switch nursing, etc. and declaring "done" when the baby starts to drift. If she spends an hour+ feeding each time, it's hard to fit in the pumping that she needs to protect the supply. This might be a good case for starting the feeding with some supplement, as a head-start on the meal, followed by "dessert" at the breast, to keep reinforcing, for a baby who's getting bottles so early, that the breast is where the baby ends up full and happy.She has to buy this baby some time, so keep discussing ways to make the plan manageable. Margaret Wills, land Quote Link to comment Share on other sites More sharing options...
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