Saw an interesting case last week, something Dr. Page may appreciate.
Was rounding in the hospital and the staff said this Mom is OK because it is
her second child and she was doing fine.  So I stopped in just to say hello
and let her know of the services we offered.  When I asked her how she was
doing, she said she must not be making enough milk because her baby was
nursing all the time.  I asked her how her nipples felt and she said they
hurt.  On exam they were very pink and then I saw her baby cry, noting a
heart shaped tip on his tongue.  What is different on this case was his
action of the tongue.  He was trying so hard to bring the tongue forward but
because it was anchored in the front the motion was over the side of the
gums, over the left side then over the right.  When I observed him on the
breast he would do this to her nipple, sliding from side to side.  Now this
is abrading the skin and poor milking of the sinuses.  I recommended she
contact her FP that day and have it clipped.  I will follow up this week.
Ann Perry RN IBCLC
Boston, Mass

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