An infant’s history can tell you what to expect on your examinations.
A mom was not able to make the initial appointment for her 17-week-old girl but sent me a detailed history. I will discuss my thinking on what I anticipate I will find on her examination.
Mom spent four hours pushing, and forceps pulled her out. Stop right there. That pushing can create a lot of tightness in the body, and the forceps can easily distort the head and create neck strain upon extraction. They are both red flags for immediate therapy.
I would expect a zero-second brain cycle and possible incipient plagiocephaly with mild torticollis. Mom said that her head was very swollen upon delivery and her nose cartilage and left ear were crooked at the time of birth—more red flags.
The baby is scheduled to soon have an ENT evaluation for a deviated nasal septum assessment. Whoa! I would suggest to delay that visit until my therapy is completed.
She also developed breastfeeding and latching issues. Latching problems make me immediately think of unilateral or bilateral TMJ strain. The infant cannot open wide to get a deep latch, allowing the nipple to reach back to the soft palate. That with a possible zero-second brain cycle from the forceps can result in a fussy baby.
The lactation consultant recommended me and a pediatric dentist. She was gaining weight slowly, but even with a bottle, developed fatigue with sucking. This is another red flag for bilateral TMJ strain where painful muscles of mastication can limit nutritional intake.
Recently, the dentist lasered her tongue tie and lip tie. In my perfect world, after becoming strain-free, I would have referred her back to the IBCLC for her to check if she needed those surgeries. Now I have to deal with all of the oral strain from birth trauma plus the scar tissue from the surgeries.
What happens during birth can be a key factor for health. Gillespie Approach Training is so needed for neonatal providers.
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