Jean said:

"Of course a 100% PERFECT off center latch would place the baby's upper
jaw in front of the sinuses and allow his tongue to extend beyond the
"belly" of the sinuses and avoid this type of pain. "

Oh, for a chance to see one of those again!  Except for my La Leche League
group, I don't.
For example this week:

1. Mom is a teen, flat, pendulous breasts - milk pouring out of thick, flat
nipples and meaty areola...and baby is a 4 lb 36 week-er who can neither
open mouth wide enough to take all this or coordinated enough to suck
efficiently once "on".

2. Mom is a 35+ with large, overly engorged breasts that have totally
flattened the nipple.  Baby has been bottle fed and given pacifiers and
pushes out with the tongue at every attempt to latch...and baby has flaccid
arm due to erb palsy.

3. Mom is 27, cracked and bleeding nipples at the base.  Baby has been
thumb sucking since (probably prior to) birth - and refuses to open mouth
more than to get something the size of his thumb in...and mom's nipples are
2 cm diameter and meaty.

(All three of these moms also had lost a baby during the last year)

4. Teen mom with very large engorged breasts so hard she doesn't want
anyone near them - and baby has broken clavicle so can only tolerate one
position.

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA

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