Star writes:

<Babies have been tried on SNS and shields, and neither have helped. I know it's hard to evaluate this without seeing her face to breast, but does anything pop out at you? Do you have any tips?>

It would be helpful to learn a little more about what happened with the SNS. Hard to imagine without a little more explanation about "not helping". The tongue evaluation might reveal a problem that prevents adequate vacuum production in the back of the mouth.

Is she nursing them individually or together? If individually, one of mom's hands could be actively doing alternate massage (when baby is not nursing/swallowing) of the upper breast to help milk move forward.

It would be interesting to know the flange size that is working well, thus possibly indicating relationship between size of nipples and/or possibly deeper lactiferous sinuses (or "collecting ducts", a term that one well known reference seems to have substituted;-) that tiny mouths may in fact not be capable of encompassing adequately.


K. Jean Cotterman RNC-E. IBCLC
WIC Volunteer LC        Dayton OH

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