These "sore nipple-clamping" cases are so difficult, there is always so much
going on. Mom's third baby, had induced rapid birth two weeks early. Baby on
O2 and did not BF successfully in hospital(RAM method used in hospital) ,
birthweight 8# 3oz.  Discharge wt. 7# 5oz. Jaundice ,ped. says to supp
w/formula baby highly orally defensive and gags easily. Doesn't bottle feed
well and is highly allergic to formula(hives and eyes swell) 3days post
discharge baby wt. 6#10oz. and one week later baby at 6#. Mom begins pumping
every two hours to supplement but baby takes long time at bottle. Mom very
sore. Thrush apparent in baby's mouth. Both treated. Then mastitis develops.
Mom very concerned about baby's weight. Her friend rec. an SNS but they can't
get baby to use it (too orally defensive).Her friend suggests seeing an LC.
I see her and baby's wt up over 9# at 6weeks. she is releived but pumping has
decrease from 5oz to 2oz and she is still incredibley sore.Somewhat tight
frenulum (mom sees DR. the next day and he clips it right there! ) We worked
on positioning and latch-on and I could get baby to finger suck (after a few
gags). Sent Mom home with some oral exercises for suck training and ideas for
increase supply. Mom desperately needs rest and better nutritions. Did I
mention baby has days and nights mixed and Mom is up all day with a 2yr old
and up til 3am with baby?!
Now Mom calls to say baby has a cold and is throwing up feeds with mucos. She
is experiencing pain in her upper arm (only during nursings) Could this be
nerve pain associated with the damaged nerves in her nipples? I would like to
get baby off the breast to give Mom a chance to heal but bottles take longer
(she uses bottle feeds a couple times a day ) and due to stress she thinks
she would have trouble pumping enough to keep up  with demand right now.
Also, she has tried the SNS with finger feeds but baby still defensive about
this.She says this pain (during and after nursing) is different then when she
had thrush. Knowing that the baby can't have formula she will continue to
endure this. I am thinking of trying a nipple shield maybe this will protect
the nipple somewhat. Things will take time here especially since rest and
nutrition need improvement first and foremost. I am going to suggest Mom
eliminate dairy since baby so sensitive to formula maybe this will help with
the clamping. Any input would be greatly appreciated....TIA
Robin in Malvern, PA