What about before and after weights, have mom pump and see what percent baby is transferring? What about trying a nipple shield (small, not large) and evaluating milk transfer with that? I attended a conference a couple of years back where in a breastfeeding clinic they were able to measure a baby's suck that mother had persistent nipple pain with no t-t and discovered for some reason this baby had sucking pressures off the charts. Used a nipple shield to reduce the pressure (in my personal research I have found that nipple shields decrease vacuum by an average of 40 mmhg) and this corrected the issue. In case studies with babies with high vacuum, able to stop use of shield at around 4 months when baby's pressures decreased to a normal level. Just something to try ---
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of TERESA PITMAN
Sent: Monday, January 28, 2013 5:17 PM
Subject: May be missing something / distorted nipples
My thoughts would be: that 8 lb. 2 ounce weight on day 4 was a mistake. Scales were off, or it was misread. It is pretty unusual for a baby to be 3 ounces over birthweight on day 4. If that weight is ignored, and you assume the normal weight loss, being 3 ounces over birthweight at 2 weeks is not too bad!
Would she be willing to try the laid-back position in hopes of improving the baby's latching, which is what I think the problem is? I'd really be focused on getting a better latch, since the mom clearly has plenty of milk.
Teresa Pitman
Please let me run the basics past you-all and see what I might be missing. Permission to Post: Mother is bfdg her 2week old girl, second time breastfeeding. Hospital birth, but completely natural with no meds. Baby weighed 7/15 at birth, and 8/2, 4 days later. She was complaining about nipple pain from the very beginning, her nipples both looked a bit pinched. [She has a brother with a minor tongue tie, which was never fixed. She breastfed him for 11 mo]. The 2wk old does have enough soiled and wet diapers. The Pedi says the bili is still a ittle high (13 I think) and wants mom to bring baby for weight checks frequently because the weight gain has leveled off. It was still 8/2 on Friday, which was at 2 wks.
She states one side (L) especially is distorted in a strange way: where the edges of the nipple core are sort of elevated when baby comes off. I have seen this before, but I don't remember understanding the cause. She says pain is a "little" better than it was two weeks ago but it still hurts. She saw the Pedi dentist with this baby at about 1 wk and dentist said no TT. Pedi Dentist said problem is "strong suction".
I checked positioning, baby's "wide open gape", stool & urine count (good), milk is easy to express by hand. Mom is able to feed for about 30 minutes in football only and she can still pump +- 2 oz after the feeding. (She wants to do that, not my idea).
What am I missing??? Help!
Isabella
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