Barbara said:
"None the less, whenever the nipple shaft is distorted in the
sucking process
to resemble a nuk-shaped nipple, tube of lipstick, or takes on a
"pinched"
shape (whatever descriptive terminology paints the clearest
picture), that
shape is diagnostic of the lower jaw compressing the wrong spot.
Why this
miss-placed compression is occuring may be related to positioning
and latch
problems, the length of the nipple, the length of the infant's
palate or
jaw,etc."
I think this is what I was trying to describe. I listened to myself
giving my usual comments to a new mom Friday, and what I actually
say is, "The only difference you should see before and after nursing
is that the nipple might look a little longer." I'm not saying it
must. This is, of course, with the average nipple "length". In
addition, nipple shape post-feed is only 1 of the 3 key points I
mentioned. The others are "no pain", and deep jaw movements. If
the only difference pre and post is that the nipple/areolar area is
momentarily elongated, but nursing is comfortable and there are good
DJEs, then in my experience it seems to indicte that nursing is
probaly going well. I have seen this when I have watched a mom with
a great nursing. That elongation only last less than a second or
so. For some moms nursing for the very first time, the first few
sucks (what I have heard described as "dry sucks"-in other words the
first few that get the milk moving) may feel surprisingly strong and
for some moms this may not mean there is anything "wrong". This is
where post-feed appearance can help. If in addition to the "Oooh"
response to the very first couple sucks, there is a funny shape
after the feed and/or no DJEs, then we definitely need to work on
refining the latch. If not, then just keep an eye on the other
indicators including diaper output.
If a mom has flat or inverted nipples pre-feed, than I think we
would hope to see them extended a bit after nursing-in other words,
closer to the "normal" shape. When these nipples look just as flat
at the end of a feeding, has baby truly drawn enough tissue into
his/her mouth to effectively elicit milk transfer?
Winnie
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