Kathy, I have worked with this type of breast/latch-on difficulty before
(more times than I would like, and they seem to drag along with a "just not
right"). What I've found helpful is this:
Help the mom get a firm "Barbie Breast" size of breast for the baby to
approach by supporting a handful and PULLING back to create even tension in the area
behind the areola. (In a few moms with REALLYlarge breasts, we ended up
cutting a 4" diameter hole in a non-nursing bra which allowed the mom to manipulate
a smaller amouint of breast more easily)
Mom makes "sandwich"shape breast for infant, really indenting breast with her
index finger, making space for babe's chin.This "breast shape" STAYS PUT,
with mom pulling back against her chest wall firmly.
Then, in the cross-cradle position, tuck the baby's butt UNDER the opposite
breast (this stabilizes the infant's trunk really well, and helps baby come
OBLIQUELY across chest, not parallel)...
Mom keeps hand really LOW in babe's neck, palm on shoulder girdle, forearm
running against babe's back, and guides infant's head to tilt back for "PEZ
DISPENSER" mouth.
I've found with the breast well indented for chin, and Mom in good control of
babe's head -aiming chin into breast first, you can get a really nice deep
asymetrical latch and will prevent the creasing you see. It will also prevent
top lip inversion. I think sometimes with small nipples and problematic
creasing, moms have a hard time distinguishing the sensations of a good vs poor latch.
And of course, there is the added issue of the abuse clouding her physical
sensations.
Successful breastfeeding can mean so much to women with a history of abuse,
my heart goes out to her. Good Luck!
Lucia Jenkins RN,IBCLC
Wakefield, Ma
"Never let the day see the setting sun without letting some breastmilk run."
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