I need help from my lactnet experts.
I have a mom with baby #1. She had a c-sec, has small nipples that don't
stick out much, and was discharged from the hospital with nipple
shields--no LC's on staff, no follow-up!!! I was called in for a consult
at 2 weeks because even with the nipple shields her nipples hurt. I did
a little tweaking with positioning and got her pain level to a point
where she could stand it--under 5 on a 10 point scale. Baby was doing
fine with wets and stools. We talked about shields and the goal to get
rid of them, but in the meantime baby wasn't interested in the breast
"naked". Baby is now 2 months, has gained like gangbusters, is satisfied
with 4-5 feedings per day and sleeping about 10 hr. at night, but mom's
nipples still hurt. She can get him on her breast without the shield,
but after less than a day feeding "naked" her nipples are sore even to
the touch. We have investigated thrush, but she has no pain between
feeds or while pumping (which she has done several multiple days of when
she is too sore to try "at breast"). I haven't seen the baby for about 2
weeks, but at 6 weeks he always looked real serious, no smiles or
giggles. Mom said that was his usual "look". At that point mom also
commented that he wouldn't turn his head to the left, she could force it,
but he would turn it back immediately. At that point my partner and I
went "ah, hah!" and suggested cranial-sacral therapy thinking that the
muscles and nerves involved could also affect suck. Mom has now had a CS
assessment and baby does have some tightness on the one side, parents
were given some exercises to do with baby, but therapist doesn't think
tightness involves anything to do with the mouth/suck. We are stuck!!!
What are we missing? Mom wants to nurse without pain. She says her
nipples were never this sensitive pre-pregnancy or pre-natally. Both
pediatrician and OB have inferred she must be a wimp.
Warmly,
Pat Bucknell, IBCLC
Avon Lake OH
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