Wednesday, July 22, 2009

The suck spot

So, your child isn't taking the dummy? needing some time off the breast?
Here's some of the tips I have come across in practice to make you understand why it takes time for the child to understand how to take the dummy - and plus how you can help.

Firstly it is important to know how the 'suck cycle' works.

This is different in bottle feeding and breastfeeding.
  • Bottle feeding sucking requires the use of the tongue being thrusted up and forward to control the milk flow.
  • Breast feeding requires the use of the lips, tongue, gums, cheeks, and hard and soft palates. This is classed as 'suckling'.
  • Breastfeeding: Typically the initial presentation of the nipple to the child's mouth/side of cheek, stimulates the rooting reflex which allows the child to open the mouth wide and enable the head to arch back.
  • The tongue then thrusts forward to pull the nipple into the mouth (N.B. this stage is important, I'll refer back to it later).
  • The contact of the nipple of the bridge between the hard palate and the soft palate, stimulates the 'suck spot'. This spot then stimulates the child to initiate suckling.
  • The tongue then begins it's rhythmic contractions forcing milk through the nipple and guiding it to the back to mouth to be swallowed. At the same time the cheeks are contracting and creating the negative pressure to bring the milk through.
So, as we know, it is easier for a child to bottle feed, and the technique is completely different to that of breastfeeding. That's why I always say that it is imperative that you firstly get the child used to breastfeeding and get the technique in-grained in the brain, before even trying something else like the dummy. (I usually say about 1-2 weeks after birth).

So you want to know how to get the child to take the dummy?

  1. First rule of thumb, be patient.
If you have a bottle feeding baby on your hands, this should be easier...
If the child is a breast feeder, this make take a little longer. Requiring a few practice rounds.

  1. Begin with stimulating the child's rooting reflex by gently stroking the outside of the cheek, this should initiate the opening of the mouth.
  2. Insert dummy.
  3. Then, hold the dummy in the mouth - if the child is a breastfeeder the initial response is to thrust the tongue forward (which will knock the dummy out), if this happens, push the dummy back in the mouth again. (recognise what i said earlier?: the breastfeeding technique is to bring the tongue forward to pull the nipple in). Of course the nipple (dummy) in this case is already in the mouth, so let the child run through her/his routine anyway.
  4. Eventually, the tongue will no longer be thrust forward and the dummy will stay in the mouth.
  5. Then, hold the dummy gently up in the roof of the palate. This stimulates that 'suck spot'.
  6. This should stimulate the child to begin the suck cycle.

SO the tips are: hold the dummy gently in the mouth, and hold it up onto the roof of the mouth.

If the child is crying, don't make it a horrible experience, try this out when the child is in the relaxed state.

Cradle Cap

Cradle cap (infantile seborrheic dermatitis) what is it all about and how can you treat it without using all the medications?

Cradle cap is prevalent in children usually under the age of 3 months, usually appearing within the first 6 weeks of life.

It is a oily, flaky, usually yellowish, scaley skin condition that is present over the areas of the body that are the most sebum rich. Typically on the top of the scalp, but in more severe cases can be over the face and trunk (this is then named seborrheic dermatitis of infancy).

It is not related to uncleanliness, nor part of an illness and is not related to the child not being cared for.

Whats the cause?
The most recent understanding in medicine is that cradle cap is related to a normal amount of yeast malassezia, but an abnormal immune response of the skin cells. This is typically related to overactivity of sebaceous glands, causing more oil to but put on the skin surface, causing skin cells to stick that would normally have been shed. Some doctors also relate this overactivity to the remaining mother's hormones in the child's circulation after birth.

Treatment
So what can you do at home without having to get to the parmacy and spend a fortune?

In the research, the most common advice is to wash the scalp regularly with a mild baby shampoo and gently comb the scalp with a baby brush to help remove the excess flaky skin.

To aid the removal of the flaky skin, another aid can be applying mineral oil or petroleum jelly to the scalp/skin over night and then gently brush in the morning to remove. Then wash regularly...

It seems that applying olive oil to the area, as I have heard, is actually not a good thing. By applying more oil (typically vegetable oil) to the area, you are allowing yeast to increase its growth and therby creating a possible pathway to secondary infection. This secondary yeast infection typically occurs more in the skin folds than on the top of the scalp. This is something to watch out for, as cradle cap/ seborrheic dermatitis should not be itchy, if it is, then it is likely that there is an underlying infection - which does require medication.

Do not use anti-dandruff shampoo. This is too harsh for a baby's skin and can create further irritation.

Do not use eczema creams (like Elidel) this is also too harsh for a child's skin and has not been tested on the under 2's.