Does this baby come off the breast easily, letting the nipple fall out?  Could be a posterior t-t which often looks good on the outside but baby has very weak suck.  Not strong enough to draw milk out. Baby can sound like he's swallowing but it be only saliva or air.  This can happen with velopharangeal insufficiency or submucosal cleft, etc. 



-----Original Message-----

From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Mandy Ball

Sent: Monday, January 28, 2013 10:19 PM

Subject: Inverted nipples and milk transfer



Mother of a 3 day old has inverted nipples and is having a difficult time getting baby to transfer milk. Moms milk is just coming in and baby latches and sucks. But after a pre and post feed weigh, there was no increase in weight. I was really surprised! I heard swallows , saw good jaw motion with sucks, and baby "nursed" for about 40 minutes total.  I tested my scale and it is right on! Mom pumped after feeding for about 10 minutes and got about 3-4 ml. About 20 minutes after feeding, the baby was crying and fussy. We gave her the pumped milk in a syringe. 

I suggested mom pump after feeds to help increase supply, help baby get a deeper latch, and suggested a pumping to help pull nipples put before feeds. I know this seems textbook, but I really expected to see a weight increase of some sort after the feeding I saw. 

Any other suggestions out there? The baby also has a bilirubin of 17 and is under bililights for tonight. 

Thank you! 



Mandy



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