Why Janie Can't Suck
Linda J. Smith, BSE, FACCE, IBCLC
Many Lactation Consultants have noticed a group of otherwise healthy, normal full-term babies who cannot suck well at breast. They may seek the breast, open wide, then STOP. Some think this is a sensory problem - the baby's oral area is affected by the medications. Others speculate on motor nerve inhibition. Still others wonder about the forceps, vacuum extraction, and other mechanical forces that are often used with medication in labor.
During the period April 1990 through April 1993, 81 mother-baby pairs were seen in my office for assistance with complicated breastfeeding situations caused by poor sucking responses. A review of the babies' charts showed:
18 (22%) had oral thrush (candida) infections
25 (31%) had asymmetrical postures, overriding cranial sutures, and/or facial asymmetry.
29 (36%) had a short and/or tight lingual frenulum
36 (45%) had been exposed to epidural anesthesia.
After eliminating the tongue-tied babies, 52 remained with impaired sucking response. Of these, 28 (54%) had been exposed to epidural anesthesia. The "poor sucking" seen in these babies was not correctable with improved positioning at breast; most of these babies also had difficulty taking oral fluids by other methods and required extensive therapy.
The following is a tentative list of possible reasons and contributing factors for this phenomenon. Unfortunately, much more research is needed in this area.
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