tongue tie and over supply

[Guest guest]

Hello Ladies,

I had a visit today that was a little different from what I

have read and I wanted to see what you all thought. Three Week old Baby number

two, baby number one just stopped nursing before the birth, he is two. Mom presented

with sputtering, clicking baby, on and off all day, major spit ups, stooling

every other day with foamy, rotten egg smelling (her words not mine) poop. I

asked vinegar she said rotten eggs. Mom's nipples were extremely pronounced

and long with a small areola. Mom suspected over supply so she had been block

feeding every 12 hours. Oral exam showed a slight anterior tongue tie.

When I observed a nursing session she had the baby belly up

and head turned toward her. I thought ok positioning correction and we should

be ok. Not so easy. Well Even after using cabbage, having pumped that side

earlier the baby nursing on that side all morning until I got there around

10:30 she latched on and started sputtering and choking and clicking. I

adjusted mom to slide down and have baby on top (laid back nursing - against

gravity) which seemed to give the baby a little more control to stop and take a

breath but the whole feeding she was flowing, feeding lasted 5 minutes. A pre

and post weight showed over an ounce in 5 minutes. Keeping her on the same

side produced the same result over again. When she was on top the baby seemed

to just stop nursing and let the milk just run out from the corner of her mouth

(and it kept pouring) and then she would start up again but she seemed so

uncomfortable. My suggestions were to really try to keep the position so that

the gravity worked against the forceful let down, burp often, peppermint to

calm the oversupply, sticking to the block feeding if she felt that was less

uncomfortable for the baby. Oh I forgot to mention that since the baby was

born the two year old has decided he wants to nurse again. Mom is a little

depressed and thinks this will be a little much for her to handle so she is

employing distraction techniques.

I was reluctant to suggest pumping before the baby latched

on to take the edge off the flow, or put the two year old up to task. I was

afraid that would exacerbate the situation. She had used the cabbage herself

and I didn't tell her that was something she should continue either. My gut is

telling me that forceful or over supply is only part of the problem and that

the baby's tongue is just tight enough that she can't really compress the

nipple in her mouth to control the flow of milk down her throat. As I said the

nipple is very long and it seems to just be more than the baby can manage.

I did refer back to doc for tt consult. Any words of advice

would be greatly appreciated .

Lou

Moramarco IBCLC, AAHCC

Birth,

Breastfeeding & Beyond

International

Board Certified Lactation Consultant

Bradley

Childbirth Educator

Certified

Birth Doula

(732)

239-7771 marylou22@...