Hi, all, update on my client with 4 wk old infant who had a sensitive
irritated feeling on bottom of nipple/areolar junction on both nipples
(nothing to see, no open areas, not yeast, good latching technique in
several positions). At home visit Saturday, we fine-tuned
latch/positioning (which looked pretty good already) and mom still had that
slightly painful sensation. I introduced a close-contact nipple shield,
baby was first reluctant to nurse with it in place, eventually while I was
there did some tentative suckling with milk transfer. I left feeling not
too confident that I had really made any significant improvement, and
thought mom might give up on the shield that day if baby was reluctant to
latch with it in place. Today during follow-up call, mom reports feeling
*much* better! She persisted with using the shield, baby learned to latch
and nurse effectively with it, mom reports continued abundant diaper
output, says "no pain" when using shield, tried nursing without shield once
last evening and once this morning and says even without the shield, nipple
discomfort is improved. I suggested another day of shield use with
occasional nursings without (since it seemed to either improve baby's
technique or reduce friction on nipple base enough to heal?), and if things
remain comfortable, discontinue shield altogether tomorrow and see how
things feel.
Still a mystery, but at least we improved the situation. Thanks for input,
those who wrote me over the weekend.
Thanks,
NancyH
Nancy Holtzman RN BSN IBCLC
mailto:[log in to unmask]
http://www.great-beginnings.com/group.html
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