This mom is looking for answers, so I have her permission to post. I did
an initial consult with her and 12 day old son on 1/30.  Mom's nipples
had vertical scabs on both nipples.  Mom said it felt like baby was
clamping down when he latched.  Digital exam confirmed that he was
pulling his tongue back with each suck. Mom was in such pain, I suggested
she pump and bottle feed EBM.  It took baby almost 15 minutes to get into
a good rhythmic suck with the bottle as per mom.  I suggested CST and mom
was able to get in for a treatment the next day.  She said she came home
and Colin latched on right for the first time!  Voila, problem fixed!  Or
so mom & I thought.  She called again 2/15 (last Saturday) and said even
though Colin was latching on "right" she was still really sore.  I
suggested follow-up CST.  Mom and baby again saw therapist who did a
little tweaking, but thought things felt OK.  I saw mom and baby again
yesterday (2/20).  Latch "looks" good, baby transferring milk
beautifully, but.................Baby fed on L breast in football hold,
mom's nipple came out with a horizontal stripe.  Baby fed on R breast
using cross cradle hold and nipple came out with a vertical stripe.
Although not pain free, mom said that the feeding I observed was "pain
she could handle" if she could be convinced Colin would feed that way
consistently.  But the tipsof her nipples both looked like the skin of a
blister that had been soaked in water for a while--"whitish", definitely
not blebs or milk-filled blisters.  The skin wasn't puffy like a blister,
just looked that type.  Left breast--the more painful of the
two--actually did look like there were 3 little blisters in a vertical
row in the middle of the whitish skin.  Mom has checked for Reynaud's and
thinks she might have a slight blanching once in a while, but no pain
when that happens.  I left her with a nipple shield and instructions on
how to use to see if it would help the pain, at least on the left side.
But I also told her I would ask my 3000 colleagues world-wide to give me
help.  What am I missing?

Warmly,
Pat Bucknell, IBCLC
Avon Lake OH

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