Fwd: Digest Number 1278

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AnnA Good Credit Score is 700 or Above. See yours in just 2 easy steps!

In a message dated 1/5/2009 12:49:34 PM Pacific Standard Time, writes:

I never refer a baby in my area to a CST. I refer to either achiropactor, PT or DO who incorporates CST into his/her practice. Myfirst personal preference here is a chiro who doesn't take insuranceand many of my clients will go that route b/c she is THE BEST. Forthose who cannot, I refer to another chiro or one of the otherpractitioners mentioned. That usually means insurance will cover. IfI had to refer to someone I did not know, I would go to the appt to besure the person knows what he/she is doing where bf'ing is concerned, When I have made referrals at a distance, I try to talk to the personon the phone or by email to find out his/her skill level with infantsand breastfeeding. A lot of CST's have very little skill with babies,even though they say that they work with babies. I try to find a PTtrained in integrative manual therapy (there is a good one inSyracuse) or a chiro who has a diplomate in pediatrics (there are lotsof them around). Or a Network chiro could be a good choice. If aDO--the person has to practice traditionally or I will not refer. Iwill refer to CSTs when they are expert with infants. There is one Irefer to in NYC and one in Northampton MA. So, my clients who pay out of pocket pay approx $100 for the intakeand $55 for follow-ups. The others pay a co-pay from $10-20 dollarsusually. While a lot of my clients have significant financial difficulties, Iam very clear that their babies absolutely must receive this care. Itis not, IMO, an option. I would say that over 95% do so. I use a ,otof anticipatory guidance to avoid the issue of moms being told bytheir peds that chiros are dangerous. I also send them articles (DeeKassing's and Sharon Vallone's) to read. And I will often have themtalk to other moms who have used CST/chiro successfully. When theycome to my moms' group, they will find that virtually every baby therehas been treated and it provides a huge impetus and lot sof support. Tow, IBCLC, CT, USAIntuitive Parenting Network, LLC

The CST practitioner to whom several of my colleagues and I refer almost exclusively is a DC who is in the final stages of completing her DC Diplomate in infants and pregnant women. She is a CST TA.

There is a very famous children's osteopathic center in SD and two of my clients successfully used the services of one of the docs, but I no longer refer to them b/c the initial visit is over $300.

, I admire your strong presentation to clients about the importance of this therapy for their baby's ability to breastfeed. Given the very 'conservative' (read totally encased in allopathic medicine and will rely on their pedi's assessment of this modality, although I preemptively explain that most medical docs are skeptical or very negative about any alternative medical practices and please call the mothers on the list, especially the one who said she was skeptical) nature of new parents, this is the end of the road. They consider bottle feeding formula a much more acceptable alternative.

I would probably word my recommendation more strongly except that Bridget and I have been stymied by some recent babies who never went back to the breast despite a frenotomy with CST f/u. We surmise that the babies had struggled at the breast too long. I could understand the two that had been FTT: not returned to BW by 3 wks and the other not at BW by 6 weeks.

They were done with the breast as soon as parents chose to intro any alternative feeding whether it be FFing w/ P-syringes, paced bottle feeding, using a Haberman, etc. We could never get them to go back to the breast, even with 'breast for dessert', even with cup feeding to encourage sucking at the breast, even with KMC 24 h per day. I think the association of struggle and hunger at the breast for so long was just too strong an association for them to overcome.

Or throw in mastitis, or declining milk production, or a milk production that wasn't great to begin with, or a move to a new apt., or older siblings who are starting to act out b/c of not having enough attention for so long, or a baby who needed a 2nd frenotomy for scarring down and b/c it was such an involved surface it needed to be done under anesthesia.

In looking back I can see all the reasons why stacking up to a baby's tipping point, but it is so very discouraging.

When I talk to parents I explain that these are the steps that we have found to help a baby feed easily, comfortably and effectively: frenotomy ASAP, f/u with CST. In some situations I refer for CST before the frenotomy. In some situations I do not recommend frenotomy first, but refer to Dr. Chelf for assessment for a non-surgical resolution. Sometimes she can balance all the muscles of neck, mouth, jaw, tongue and eliminate the PTT. Some she can't. But those who have had more CST work done before the frenotomy have a faster return to Bfing than the ones who do the frenotomy first and a CST f/u.

The ultimate 'decider' is the baby. There are babies who we catch earlier, and they do everything 'right' and baby still won't go back to the breast.

Several of your sgs for 'breaking in' a new DC/MT/CST, etc. are so helpful, . Thank you for sharing all your experience with us. You are helping the field of lactation move forward or backward to tour roots.

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