Last change: 04/29/2001
How to recognize that an infant´s mouth region is hypotone
- The infant sucks badly or not at all from the breast.
- Drinking from a bottle is difficult or not possible.
- Possibly the infant cannot make an adequate vacuum (there might be a gap in the corner of his/her mouth).
- Some hypotone infants do not have a sucking reflex, some others have a decreased one.
- Sometimes the rooting reflex is missing as well, but not in every case.
- If the infant´s problem remains undiscovered he/she will lose weight all too rapidly (our son did not even show
that he was hungry but slept most of the time).
- The philtrum (region between upper lip and nose) looks flatter than that of healthy children.
- The complete facial muscles may be less "active" than those of healthy children (diminished facial expressions).
- Possibly the infant´s muscles expressed a decreased or - elsewhere - increased muscle activity (muscle tone)
before or after birth / perhaps arms and/or legs were more stretched out than those of healthy children.
- The baby smiles less to not at all.
- Have a lot of patience! Stay cool!
- Do not think your child rejects you! She/he cannot smile/suck but she/he would love to!!!
- Make sure that the infant takes on weight (it is OK if your child can swallow adequately - if necessary, tap your
child on the back). An infant who cannot suck but swallow, does not have to be fed by a naso-gastric tube, i.e.
fed via a little tube from his/her nose to her/his stomach - often a bottle i.e. teat with large holes will do!
(If necessary, use a teat for mash.)
- Should your baby really need to be admitted to a children´s hospital, see to it that he/she is only tubefed in case
there is really no alternative solution - as experience shows that otherwise an infant can less easily learn to suck
because of the incentive missing.
- The best thing to do is to express milk (with a good electric breast pump - you´d better try different ones first!)
and to build up a good milk supply (I found that special teas were a great help - you can ask in a drugstore or
ask your midwife for a source of supply.)
- As the baby´s sucking would add more to the building-up of your milk supply than you can by expressing you
have to express more often than a baby would normally suck (up to once an hour during the day, a little less
often during the night). By doing this you can feed breastmilk with a bottle or begin with breastfeeding even still
after weeks. So the baby takes advantage of the breastmilk. However, you need to have a lot of stamina and
get a great deal of support. You have to practise together with the baby (at least three times a day - in addition
to expressing milk)!
This is a strain on your nerves and costs power and sleep! But you can console yourself with the fact that your
baby at least receives antibodies from the breastmilk against various illnesses, and, apart from that, children
who are breastfed do not develop as many allergies as others do.
Exercises for you and your baby
- Massages inside the mouth - according to the instructions of midwifes, physiotherapists, physicians - or a
qualified breastfeeding counselor can help to increase the muscle tone.
- Try breastfeeding your baby as often as you can stand being not successful during the first weeks. (Many more
women will succeed than most specialists think!). In our case all of them had given up but Andy showed them
what he was able to learn - at about five weeks of age! (By the way, I learned from the mother of a child who
has the Down Syndrome that it took her baby five weeks as well to learn how to suck from the breast.)
- Make yourself feel comfortable.This is very important because of the many breastfeeding tries (e.g. use a special
cushion for breastfeeding!) So you do not strain your back in addition.
- A lot of support from your partner/family - by breastfeeding or trying to do so you do an important
task that is work enough! And when you eventually succeed in breastfeeding your child this will be the best
physiotherapy for his/her mouth region - e.g. for the prevention or diminishing of speech problems (articulation)
due to the hypotonia.
- You can possibly support your nipple from its rear side through the areola with your thumb - so it remains in
your baby´s mouth more easily.
- By positioning the baby in a special way you can possibly improve the vacuum the mouth should make. (A
qualified breastfeeding counselor can show you how.)
- You could express a little bit of milk right before trying to breastfeed your baby in order to improve the
flow of milk (activation of the let-down reflex). So it is easier for your baby to start sucking.
- Try to make some breastfeeding exercises together with your partner. He can, for example, help to make the
vacuum needed (push the breast against the mouth (but not the nose!) of the baby or help with the
- By combining giving bottles (against your baby´s hunger i.e. to make sure that your baby takes on enough
weight more rapidly) and the so-called finger-feeding (possibly alternating) you can feed
your baby until she/he has learned how to suck. (Finger-feeding is a method to feed the baby with expressed
breastmilk with a kind of injection-and-tube tool which you can use to "inject" the milk into your baby´s
mouth. It keeps the infant from becoming used to drinking from the bottle too much. Qualified breastfeeding
counselors and midwives show you how it works.)
- It is a good idea to get into contact with a breastfeeding oder other support group (ask your midwife where).
And: Never give up too early!
Even if you can breastfeed your special baby only partly - or the fact that you can give him/her your breastmilk (by finger-feeding or, if there is no alternative solution, with a bottle) improves your self-assurance and can bring you and your baby closer together. So you get a little bit of the "normality" back that you had dreamed of during pregnancy.
Of course breastfeeding cannot make your baby healthy but it indeed give your baby incentives for his/her development: Although I really was not cool at all during the first days and weeks when I thought my baby rejected me, and although I sometimes said things to him that were not justified at all, Andy developed very well if you consider what disease he has. And the difficult lessons he took in order to learn how to suck from the breast have added to this a lot!
By the way, dear daddies, a good book on breastfeeding can be an adequate present of support for your wife!
Best wishes and good luck for your breastfeeding "lessons" to all involved!