Dear Lactnetters,

I am a CLC and I used to be able to read my lactnet mail daily until  
I had my second baby and I am sorry to say I haven't been much since  
(he's now 9 months old).

I have however, been to see a few women with some problems and I have  
encountered a bit of a challenging situation.  My client is from  
India and her english is functional but somewhat limited in this  
particular area.  So we are having some difficultly communicating  
about the situation.
When I first went to see her, we talked about the importance of a  
correct latch and we put the baby on a few times till it was good.   
She wasn't experiencing any discomfort while she nursed her baby but  
after she was done she complained of pain in her breast (behind the  
nipple area).   I am not sure if this pain is outside or in.  I  
couldn't quite get that.  The thing is she says it only hurts if  
she's not wearing a bra.  So the weight of her breasts seems to be a  
source (???).  It's both sides that hurt.  But only AFTER nursing.

I've just been back to see her again (one week later) and she says  
that still she is NOT experiencing any pain or discomfort WHILE  
nursing but that it hurts after.  She also says that everytime she  
feeds the baby the baby starts crying again after about 1/2hr to 45  
minutes.  Sometimes as little as 15 minutes.  I really really believe  
that the baby isn't latching properly.  I didn't get to observe her  
last night has her husband had just given the baby a bottle of ABM.   
Mom thinks it's something she's doing (or not doing).

I looked at her nipples and they both have bad crescent shaped cracks  
on the outer ring of the base of the nipple.  (Right where the nipple  
meets the areola).  So her left nipple is cracked on the left side  
and the right nipple is cracked on the right side.  This is  
definitely a latching issue but even after I speak slowly and  
succinctly to try to get it across about the latch, she seems not to  
understand.  I told her what to look for, how to position the baby,  
all about waiting for the "yawn" and like I said when she latches,  
Mom says she's feeling fine and nothing hurts.  But sore, cracked  
nipples like I've described can only come from an incorrect latch,  
right.  Also, sounds like baby isn't transferring much milk if she is  
crying after feeds and then becomes settled if given a bottle.  (??)

This pain AFTER nursing though, could it be reynauds (sp?).  Her  
nipples don't blanche, but they do get red (she says they are but the  
don't look red to me).   I have very limited experience and I am  
hoping you may be able to give me tips on how to help her.

Many thanks in advance,


cian t. sawyer, CLC
Nassau, Bahamas

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html