Just a head's up... there are changes coming. Be on the lookout!
Last week, I took Ruby to a feeding specialist (an occupational therapist that specializes in infant feeding and sucking issues) and had her evaluated. I was introduced to her by a mutual friend, and thought it sort of a last-ditch effort in my desire to not have to wean Ruby. Nurse Nice or Quit has been leaning heavily towards quit.
Within minutes of entering the room with this woman, it became readily apparent that she knew her stuff. The first thing the mentioned, upon seeing Ruby smile, was that her top lip had no muscle definition. She asked lots of questions and played around with Ruby, eventually doing an evaluation on her mouth. We were there for nearly two hours.
In the end, we discovered that Ruby has a myriad of oral motor issues. In addition to her lack of lip muscle definition, she has no central tongue groove, which should be present very early on. Ruby also still has her ‘buccal fat pads’, which should go away very early on. During the evaluation, Ruby didn’t seem to be able to “lateralize” her tongue (move it to the sides), nor did she appear to have any gag reflex at all.
The OT showed us a bunch of stretches and exercises to do with Ruby, as well as giving us a “Nuk” brush to stimulate her tongue with, and encourage the development of her central tongue groove. She asked us to do the stretches/exercises three times a day for three weeks, after which we would have a follow up evaluation and make a plan of action.
I can confidently say that after a few exercise sessions, I have seen a difference in Ruby already. She is moving her tongue more, using it to push her food around. There is a hint of a central tongue groove developing. I can’t say anything about her buccal fat pads, but just continue to do the stretches that should help them to resolve.
As far as breastfeeding is concerned, the OT and I discussed and agree that Ruby’s behavior towards the breast is probably exactly that – just a behavior. It may be one that was created out of necessity due to her oral motor deficiencies, but it is one that continues because that is “normal” for her. We will continue to pursue the resolution of her issues, but it may not solve any of our problems; that will have to be something we un-learn – or don’t – on our own.