Physical Therapist for sucking issues in preterm baby?

[salt_phoenix]

I have never heard of this, however, my LC told me I might be able to get some help for my preterm baby (now 6 weeks old) and her sucking problems. I am so devastated. She hasn't been transferring milk, even though I thought she was latched on good enough, and actually LOST weight!!! She's only 8 oz. over her birth weight, now at 6 weeks old!!!
I am back to pumping like crazy and giving her a bottle of frozen EBM to try to get her back on track.
She will still "latch on" the breast, but I guess she's not emptying them at all, she's not even getting much out of them, so it has resulted in dropped milk supply. I'm now on dom & all the usual things to build it back up. Thank goodness for freezer stash BM.
Anyone ever hear of PT for sucking problems? How can a LC not help, and a PT help?
Any advice would be great, my little baby is so tiny and I am just devastated that the very thing I thought would be best for her, was nearly starving her to death.
This has been very hard for me, having a preterm baby with nursing issues, as my other two were mostly issue free, nursing each for 2 & 1 year. I've never had supply issues, latching issues or anything else. This is awful.

[boheime]

I would recmmend an Occupational Therapist (OT). They can check out her sucking issue and give you exercises that you can do with her to help improve it. I would definitely recommend that.

Another option (that I would check into in addition to the OT) would be to see someone who does cranio sachral therapy (CST). Some chiropractors are trained in this.

[nausicaamom]

You may want to look into getting a feeding evaluation done and suck training with either an occupational therapist or more likely a speech language pathologist (SLP) - the SLP specializes in this area and may have more expertise than an OT or PT.

[veganone]

How early was babe? DD was a horrible sucker until she was at least a few weeks past her EDD. We did triple feeds, but I don't see how consulting a PT or CST would hurt.

In the meantime, are you triple feeding? I truly believe that the time spent nursing before getting the supplements are what got her attached to bfing. If you can - I would keep nursing and then supplementing so that she is still getting the practice with nursing to make the transition to exclusive bfing easier.

Hang in there, momma. It's really hard with the early ones.

[Vanishing Word]

Hi mama!
It can be normal for preemies to take a little longer to get the sucking reflex mastered! They tire out a bit more quickly. ((hug))
What sort of pump are you using now? How do you feel like that is going for you? Could you tell us more about your milk supply?

Here is a good link to body work with babies: http://www.icapediatrics.com/referen...Breast-Feeding

[shelbean91]

We didn't see a PT w/ds1 (who also had LOTS of sucking issues). We did end up seeing a speech therapist, but it took so long to get an appt, that by the time we got in, the issues had resolved (4 mos).

[salt_phoenix]

Originally Posted by veganone

How early was babe? are you triple feeding?

She was 34w6d
I nurse, then give her a bottle of breast milk (while freezer supply lasts) then pump.
She doesn't get much from the breast... she just doesn't transfer the milk.

Originally Posted by Vanishing Word

What sort of pump are you using now? How do you feel like that is going for you? Could you tell us more about your milk supply?

I have a good pump, however before that, I got engorged a few weeks ago and wasn't able to pump it all out and my supply plummeted overnight.
I get exactly 2 oz. every 3 hrs. now. Seems pathetic. Soon (within a couple of days) my freezer stash will be gone and I will have to give her formula.
I haven't noticed any difference with the dom (been on it a week now) and pumping every 2 hrs. during the day hasn't helped either.

I keep thinking that "if only" she would nurse "correctly" I could get my milk built back up. She will latch on and nurse for a long time if she's not too hungry, but it doesn't seem to stimulate any more milk production without the transfer. All it is is nipple stimulation, I guess... I dunno.

Very frustrating and I have been at my wits end for weeks. I just feel like the LC's (two different ones) have just given up on me and trying to send me to someone else... that's why I asked about experiences with PT's and such. I'm just worried that it's "just one more thing" to try, that will go just as horribly wrong as everything else I've tried. (SNS, nipple shield, tinctures & dom, etc)
Dh is going broke because of my obsession with trying to nurse this baby... He might do better buying formula.

I can't believe that she can finally nurse, only to find either not enough milk, or none that she can actually get into her belly.
What a nightmare.

[purplepaisleymama]

As far as I know both SLP and OT are covered by insurance when needed for a feeding issue. I would call your local birth to three and mention that the baby is not eating well and that she was a preemie. In our area preemies are covered for early intervention because they are more likely to have feeding and tone problems. We were told when our youngest was born early that we would qualify for EI because he was a preemie, though he would have to have been 7 weeks early or under a certain birth weight to be automatically enrolled in EI.
I would try to get the names of local OTs and start from there, mention to everyone that she is having feeding issues so that you will be able to get the earliest appointment possible.
I don't think that the LC's are recommending the Therapists to pass you along, they are trying to get you the people who specialize in this sort of thing. Our youngest had alot of tone problems and they did have an effect on his nursing, he could not lie down to nurse for the first 6 months and was a very difficult nurser in every way. A very close friend whose son is 2 weeks older than mine had similar problems and their son had a OT who helped them with some positional and muscle issues, they were helped through EI.
Hope that you get some help soon
Laura

[MaryJaneLouise]

for working so hard on this!

You might need some help with your supply issues to help you along until you can get babe back to breast. Please see the "low milk supply" stickie at the top of this forum to help you with your pumping. I hope your supply will rebound pretty easily since you had good supply in the past.

[doularosemary]

When my full term homebirthed dd had latching issues that the LC could not solve we were referred to an "Infant Feeding Specialist" at a local children's hospital.

Aparently infant feeding specialists can be either occupational therapists, physical therapists, or speech therapists. Just make sure they are also trained in infant feeding issues.

[GooeyRN]

I had issues with ds not transferring milk even with a good latch and a fabulous supply. He lost weight and couldn't regain his birthweight until almost 4 weeks old. He became very jaundiced, wasnt pooping, etc. He had a weak and lazy suck.

I still avoided bottles. I pumped and put the milk in an SNS and he started gaining and pooping immediatly. I slowly transitioned to not using the SNS. It kept him at the breast so he never got nipple confusion/preference.

Things turned out well for us. We were off the SNS by 6.5 weeks old. I did buy a baby scale to monitor him closely. PM me if you have any questions or want to vent about how much your situation sucks.

[veganone]

When was/is your EDD? DD really did take a long time to get effective at nursing. I had a miserable time keeping up with her as well, but 2 oz every 3 hours seems like a pretty decent supply to me at that age. I never got any more than that while we were triple feeding.

How frequently do you nurse and for how long? Are you off the NS now? Has an LC weighed baby before and after a good feed to see how much she's getting?

I surprised myself when I decided to cut back on the supplemental bottles. I just cut out one a day and she did fine and continued gaining.

I also had to use supplemental formula for a few weeks, but by a few months we were exclusively nursing and doing great. I would definitely use a good probiotic if/when you do that. But, that does NOT mean you won't be able to keep bfing. Keep nursing before every supplement and pumping at least 6-8 times a day to protect your supply.

You CAN get through this. It really is only temporary. LO will get older and stronger and more effective at sucking and suddenly you'll just be nursing!