Permission to post.
Spoke with a mom yesterday about her seven month old son and several issues they are having or have had with nursing.? I am over my head with some of these and would like some thoughts on what to recommend to mom.
First, I am in El Paso and she lives in Clearwater, TX (near Houston).? Her cousin, in El Paso, contacted me to see if I had any ideas for mom subsequent to a nursing strike.? I have not seen mom and baby nurse so all the info is just from what mom described to me on the phone.? We have had one 45 minute conversation.? This is all over the map, bear with me!

Baby had shoulder dystocia and midwives used traction to assist with birth.? He seemed to nurse well in the birth center but during a post partum visit at home the midwife was concerned that he was not latched well? / transferring milk well.? Latch was "fixed" but mom still had pain.? Baby has been to chiropractor four times since birth.? Chiro uses an activator and baby fights and cries when activator touches his back.? Mom also mentioned that when she touches baby's back / shoulders during nursing he will arch away and cry.? She has large breasts and so lays him on a pillow and uses a modified cross cradle hold so isn't touching his upper back / shoulders much during most nursing sessions.? In the week prior to the nursing strike mom felt like things were finally going well.? 

At about six weeks of age mom read recommendation to nurse in a quiet, dark room.? She started doing that and he seemed to nurse better there so she continued.? Soon baby wouldn't nurse anywhere else.? Nursing while away from home didn't go well.? She had to go to the car to nurse and that didn't always work.? Since the nursing strike he has returned to the need for total dark and quiet.? He must be swaddled and have absolutely no light, even light from under the door or he won't nurse.? If he sees light he will cry and refuse the breast.
Mom started using a sippy cup with a straw with water.? She states that when he drinks from it he fills his mouth with water but doesn't swallow all of it.? She was concerned about using bottles during the nursing strike but felt like she couldn't rely on the sippy cup because so much EBM would be wasted.

A local IBCLC has worked with them and stated she thought baby might have a tongue tie.? They took baby to the midwife to have the frenulum clipped but she told them that the baby didn't have enough to clip.? (This sounds very odd to me!)? That was my first comment to the mother's cousin when I read the issues she had had with pain throughout the past seven months, baby might have tongue tie.

Baby also has reflux and has been on meds for about 6 weeks to date.

My recommendations to mom were: 
1.? see ENT to evaluate tongue tie.? Does anyone have a recommendation for a breastfeeding friendly ENT in the Clearwater area?
2.??see neurologist to evaluate baby.? Does anyone have a recommendation for a breastfeeding friendly?neurologist in the Clearwater area???????????????????????????????????????????? 
3.? attend a LLL meeting to support mom's efforts.? She attended a meeting and it was not a good experience.? Not sure what the issue was.? Any recommendations on this one?
?????????????????????? 
I told mom I am over my head on this one, especially because I haven't seen them nurse.? She is anxious to hear what suggestions and input you wise ones have for her!

TIA, 

Christie Pillado, IBCLC
El Paso, TX


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