About Pia's case, it is worth looking at baby's lips as well.  Labial
frenula can cause baby to keep the affected lip tucked inward, and in my
experienced this is often associated with a crack at the base of the nipple,
on the side where the affected lip is placed.  If it is baby's lower lip
that is tucked in, the crack is underneath, and if it is the upper lip, the
crack is on the upper aspect.  

Either way, milk transfer is affected because the baby is not using cheeks,
tongue, lips and jaw effectively and in concert during suckling.  

I would also be tempted to point out to whoever is treating the baby, that
if mother were not breastfeeding another child, her production would
probably have decreased to far less than is needed.  The tandem nursing is
what has saved this baby, not threatened it.

Rachel Myr
Kristiansand, Norway

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