# high palate, tongue thrust, shallow latch



## wendy1221 (Feb 9, 2004)

Hi, my babe is 2 days old now. When he was born, I asked my mw to check for tongue-tie b/c my first 2 were t-t and my 2nd was pretty severe and it caused a lot of problems. Well, she said his frenulum is a litte thick, but nothing that should cause problems (he doesn't have the heart shaped tongue my 1st 2 had), but that he has a high palate. She didn't think the high palate would cause problems b/c I have long nipples, but I'm wondering if it has something to do w/ the trouble we're having. He's swallowing more air than milk right now, or at least that's what it seems like. There's a horrible clicking noise when he nurses and he's incredibly gassy. He's not showing signs of dehydration, but he's not wetting as many diapers as I'd like (I have milk but it's not in fully yet.) He will not open his mouth wide enough and the few times he does, his tongue is up. He also usually gags if I do actually get a lot of nipple in. It seems like all I do is relatch and relatch w/out any results. Actually, my mw was here today and gave him a neck massage adn told me to take him to the chiropractor b/c his neck is very tense (he was born w/ the cord around his neck and his shoulders hunched up and sideways, so they came out together.) Since she did that, he latches right maybe 1 out of 10 times. But he only stays on there good for 1 let-down, and then he pushes it out w/ his tongue and starts clicking again, so I unlatch him and he sucks his tongue and falls asleep and then wakes up 10 minutes later rooting and needing to burp. I'm getting really frustrated and I'm SO TIRED! It also doesn't help that my 2yo doesn't want to do anything but nurse since yesterday and is contantly pulling at me and crying.







I was hoping someone might have some suggestions. I called my LLL leader, but she said if he's getting milk and I'm not sore (I'm not), then maybe I shold just leave it go and it will resolve itself in a few weeks. But I don't want him to form bad habits. Ds2 still needs to be relatched pretty often b/c of the latching habits he got into before we got his frenulum clipped. Thanks for any suggestions.


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## its_me_mona (Feb 2, 2005)

Hi there. Congrats on the new baby







I have to say that I agree with your LLL's advice, except that I'd just add that you should do your best to accept nothing less than a perfect latch. Some babies will tolerate being unlatched and latched back on while others will not. You know your baby best - if you think he can/will tolerate it then make him latch on properly. But remember, he's only 2 days old. Give him a few weeks to figure things out









I'd keep trying to get as much of the nipple in his mouth as you can by making a "breast sandwich" (sometimes referred to as a nipple sandwich too). And go back to your basics of positioning and latching. Even veteran nursing mom's (I'm one of them!) sometimes need a refresher course in positioning and latching even if they feel certain they're doing it perfectly.

It sounds like your milk has come in though if you are feeling let down and baby may be getting everything that he needs after that first initial let down. Remember, at this point in time your baby's tummy can't even hold 7 cc's of colostrum or milk









Hang in there, go back to the basics and just be patient. He'll get it soon!


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## linny (Apr 19, 2005)

Hi Wendy,

I just wanted to say that what you described is exactly what my dd and I went/am still going through. Tongue up all the time, tongue sucking/clicking, high palate, neck problems, gagging on the nipple. and sensitive gag reflex.

Things that helped us were cranialsacral therapy to loosen the neck, throat and tongue. Tongue is still up most of the time and she sucks on it a lot but not as bad as it was initially - btw dd is now 10 weeks old. Also a nipple shield (we are using it under the guidance of an IBCLC). The shield hits her palate right where she seems to need it to suck. I'm in the process of trying to wean her from the shield and am able to get her latched and nursing occassionally bare breasted. Suck pratice helped with the tongue - just place your index finger or thumb nail side down in your dc's mouth and allow them to suck. It teaches them to keep the tongue down while nursing.

Once she got a bit bigger and more experienced the clicking during feeding decreased (clicking is the breaking of the suction).

I hope this helps you out.

Linda


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## Fujimama (May 4, 2004)

:

Need tricks/tips/advice for the same thing.


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## anamarsy (Mar 6, 2005)

My now 5 month old dd also has a very high bubble palate. She made loud smacking noises for the first 4.5 months of her life while nursing. She gained weight ok for the first 2 months or so, but not great weight gain. Around 2.5 months, her weight gain really slowed down. When I took her to the LC, she was only taking in 2 oz total and this was at 3.5 months, not enough milk for a baby that age, which was why her weight gain had stopped. B/c of her ineffective nursing, my supply had decreased.

Anyway, I started pumping after every feeding with a Medela Classic I rented and giving her extra milk. Immediately she started gaining an oz. a day. I was so upset about having to pump and do so many bottle feedings (we tried the Lactaid but she would cry and scream even more when I tried to use it). I was worried she would start to prefer the bottle over me, but she never has. She's done fine going back and forth between the two. After 2 weeks of the intense pumping, I had to cut back to 3x a day and would give her formula if I didn't have enough milk.

Fast forward to about 1.5 weeks ago- I had been noticing that dd was nursing longer and not making the smacking noises anymore. So I started doing feeding weights (I have hte special scale rented) and she was taking between 3-5 oz every time! I was so happy, as she had been still taking around 2 oz last I was checking.

So over the course of a few days, I dropped the pumps and replaced them with nursings. I am a little nervous and am checking her weight gain, but am so excited to be back to exclusive nursing.

Anyway, just wanted to share my story so you can be careful to check your baby's weight and make sure he's getting enough so you can do what you need to keep your milk supply up in case he's not nursing well enough to do so.


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## studentmama (Jan 30, 2004)

Congrats on the new baby!!
I don't have much to add, but maybe this link will help?
http://www.kellymom.com/bf/concerns/...n-nursing.html

Good Luck and keep us updated.


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## rozzie'sma (Jul 6, 2005)

good for you


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## wombat (Nov 3, 2002)

My experience was much like anamarsy's. I had to pump almost from the start to keep up my supply and it took til 16w to get to exclusive nursing. My nipples were a bit flat though. I think how long it takes to resolves varies a lot - depends on the fit between his palate and your nipples. It sounds good that your nipples are long and you're not sore. Maybe it'll resolve quickly. My dd had that clicking noise also.

I can't say any one thing really helped. but experimenting a lot with positioning. I needed dd really high up. Nursing lying down was out til she almost 6 mo. Then the asymmetric latching technique all LCs seem to recommend didn't work for us. Just going bullseye seemed better. And a hell of lot of patience. Know what you mean about having to relatch all the time. If I'd have kept trying to get the 'perfect' latch, dd would never have got fed in the early days.

I rented a weight scale too. It was easier than having to get the LC in all the time and gave me peace of mind.

I've also heard good things about cranial sacral therapy. I didn't try it but if I had the same problem again, I'd just try it.


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## katerkat (Aug 13, 2005)

We had similar problems and ended up with a nipple shield for about two months - it trained him to pull the nipple all the way into his mouth. DS has been weaned off it for 4 months and I still have to poke his chin to make him open wide, and correct his latch.

He also has a neck problem - torticollis - which my PT and LC think contributed to the problem, since he nursed worse on his bad side.

He always "clicks" - my LC said that's how you know he's swallowing?


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## wendy1221 (Feb 9, 2004)

Thanks! I should have replied sooner, but this babe is like his oldest brother and I can't put him down for a second!

My milk finally came in fully the night after I posted. Since then, he has been latching better and better and is actually a pro at it now. My mw said he probably didn't like the taste of colostrum and once my milk came in, it was incentive to suck better. He does still tongue thrust sometimes, but I"m hping our appt at the chiropractor helps with that.


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## linny (Apr 19, 2005)

I'm glad that things are working out for you. My dd was similar - she worked harder and better at nursing when there was milk available (but for us I had to use a SNS for a couple of weeks) for the reward.

Hope it keeps getting better and better for you two.

Linda

ps. thanks for responding to my email. Got an appointment with an ENT tomorrow afternoon.


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## sarahwebb (Feb 12, 2002)

Hi Wendy,

Congratulations and good luck! I'm so glad the latch is getting better. Please pay attention to your baby's weight gain though. That's really the key. I rented a Medela Baby Weigh scale to test how much my high palate baby was getting per feeding. I lost my supply at two weeks because my baby was sucking efficiently enough. Your nursing toddler may help keep your supply up, but please keep a careful eye on things. You may also find that even if your baby isn't severely tongue tied, having the frenulum clipped might help.

With my baby, I worked with several IBCLCs. The independent one was the best. We also had his frenulum clipped by an ENT and worked on suck and oral training with an occupational therapist. Like Wombat, if I was faced with this situation agian, I would find a cranio-sacral therapist.

I pumped for my baby for a year. He kept nursing after I quit pumping, and now at 17 months, he finally seems to be nursing really well. If you want to know more of my story, you might do well with an advanced search on my user name and bubble palate. I don't have the energy to retell it all again; I hope you understand.

The one thing I have to say is: YOUR LLL LEADER IS WRONG. Most times, her advice would be fine, but if you have a baby who really can't nurse well, you'll lose your supply and the baby will lose weight. I attend LLL meetings; I love our leader, but if I had followed LLL advice, I don't know if I ever would have salvaged my nursing relationship with my son. LLL is great for community and support, but they often aren't equipped to help with major nursing problems.

Best,
Sarah


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## its_me_mona (Feb 2, 2005)

Quote:

I called my LLL leader, but she said if he's getting milk and I'm not sore (I'm not), then maybe I shold just leave it go and it will resolve itself in a few weeks.

Quote:

YOUR LLL LEADER IS WRONG....LLL is great for community and support, but they often aren't equipped to help with major nursing problems.
Actually, if you look at Kellymom who is an IBCLC, even she says that if mom's nipples aren't sore and baby is gaining weight then the baby's latch can be considered "good" even though it's not textbook. ~ http://www.kellymom.com/bf/start/bas...resources.html It looks as though the OP'ers issue has resolved itself though, which is great!

I imagine that there are some less educated LLL Leader's out there. However, the vast majority of them have not only dealt with their own major nursing problems but they've worked with dozens upon dozens of other mother's with major nursing problems. As a whole, LLL Leaders tend to have more personal experience with nursing than LC's at hospital and are typically very educated on a variety of nursing issues. I've been less than impressed by non-Board Certified LC's.


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## wendy1221 (Feb 9, 2004)

My LLL leader also happens to be an IBCLC (which I only know b/c I was referred to her through WIC w/ ds2. She doesn't tell the WIC clients she's a LLL leader and vice versa. I only know cuz I've seen her through both.) She asked me about hearing him swallow milk as well as air and about his wet diapers (which I said weren't as many as I'd like, but my milk also wasn't in completely yet.) She did also call me again on Wednesday to make sure he was wetting more since my milk was probably in by them, and was going to come over if I was still having problems. She had tongue-tied babies herself and was a tremendous help to me w/ ds2. I just wasn't completely comfortable w/ the idea of a less than perfect latch, so I thought I'd see what the ladies here had to say. KWIM? Anyway, I really appreciate all the help and I hope the advice will be helpful to someone else as well.







Good luck to those of you still having problems. I admire your perseverence. (I hope I'd be able to do the same if needed.)

Oh, as for his weight gain, I'm not big on scales. His cheeks are noticably chubbier and he pees A LOT! So i'm not worried. I use cloth dipaers and he's been SOAKING through them pretty regularly. I thought I'd put disposies on him at night for a while so I wouldn't have to change diapers so much and he's been peeing through those in just a few hours as well! And he pooped 8 times yesterday, and pooped completely out of his diaper and sleeper already today (mainly b/c we were out and I put a sposie on him. I forgot why I hate those so much!) So I think he's doing well! LOL! Oh, and also on Wednesday when my mw came to check on us and do the newborn screening (the heel prick tests), when he was 4 days old, he was only down to 9lbs even from his birth weight of 9lbs 6 oz, so that's not too bad. He must have been getting something. We're going to see the chiropractor at 4 today, so I'm hoping that helps w/ the last of these problems. He's still not opening quite wide enough all hte time and I can feel his tongue moving to the wrong place sometimes, but he's definitely doing much much better.


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## its_me_mona (Feb 2, 2005)

It sounds like both of you are really doing great, Wendy. Keep up the good work, Mama!


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