I have been dealing with a simlar situation. I posted about the dyad a few weeks ago; a mother dealing with both over-supply and blisters on her nipple (thanks for all of the suggestions, BTW!). Many have been very helpful to the mom.
Because she is someone I know casually through a mom's group, I did a home visit a couple of weeks ago. I notced 2 important things (at least to my rather untrained eye): baby's latch was very shallow, and I couldn't see his tongue. We worked on getting a deeper latch, and talked about the possibility of tongue tie. Baby has been seen by his ped and 2 LCs. All stated that he had no tongue tie. The baby is about 5 months old, and mother stated that he has never stuck out his tongue. When he opened his mouth, it looked VERY short to me. I am a lay person, so I cannot offer any sort of dx, but I did offer to help mother get into contact with out local LLL PL person, who is an excellent IBCLC.
I also reccomended some exercises outlined in the Breastfeeding Answer Book to encourage baby to extend his tongue. The mother reported less nipple pain when I saw her last week at the park.
She stated that the MDs and LCs all waved off her concerns about the tongue with only a cursory glance. She does not feel the need to see yet another professional at this point, as she is more comfortable and baby has always gained well (he's a little chunker!). I hate to think of her just bearing the pain because 3 medical professionals have told her there is nothing wrong. I am attempting to gently encourage her to see the aforementioned IBCLC. We'll see what happens.I hope she decides to see this wonderful LC sometime soon. We have many MDs in this area who see brastfeeding as optional, and it seems that her baby's ped is one of them. Fortunately, because we are such a densely populated area, there are also plenty of great MDs who actually know what they are talking about when it comes to more complicated breastfeeding issues. It is a shame that she is "powering through" the discomfort when there MAY be a very easy fix to the situation.
In addition, when she saw her OB at her 6-week checkup, the blisters were very painful. The OB told her that they didn't look "that bad" and recomended warm compresses. That was all. No referral to a good LC, or even to LLL. Mom was experiencing SEVERE pain. However, she was dedicated to breastfeeding, so she just gritted her teeth for a couple of months until it subsided a little. Perhaps the baby's mouth got a bit bigger and his latch deepened a bit, perhaps his tongue got a little more elastic because of the exclusive breastfeeding. I have no idea. Again, I;m not a healthcare professional, so what do I know??? I have learned from more experienced LLLLs and LCs that if mom is in pain, something is wrong. Why did her OB, the baby's Ped, and the other LCs she saw not see this as an issue? She is a rather soft-spoken woman. Maybe she did not make her discomfort understood. Still, she insists that she told everyone that she was in severe pain, and basically got a pat on the
head and the recomndation to just wait a few weeks for the problem to resolve itself. She was VERY upfront with me about her level of discomfort.
Again, I am only a lay person, but everything about the situation screams "tongue tie" or "short tongue." I wish that the baby's primary MD had the knowledge or interest to pursue this further. I hate it when the baby's mother has to be so aggressive in advocating for the dyad, or when I, as a lay helper, have to do so. If only we had more Dr. Jays in the world. If every Ped had 1/3 his level of knowledge about breastfeeding, my (unpaid and mostly thankless) work would be much easier! Grrrrr.
--Kellie Whitney, Cranky LLLL
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