Hi Karen,
You ask if very loose, mushy, soft areolar complex can be affecting milk
transfer. The short answer is YES, in my experience.
I *assume* that the weight gain and/or other signs of effective feeding were
not present, and therefore, further evaluation was done. This included ac/pc
weighing and pumping milk (I assume again). The pumping might have been done
to ascertain milk production levels, and/or to provide milk for the baby who
needed it.
However, could baby have had delayed or infrequent bf? Could baby have had
too much mother/baby separation? Could baby have been bottlefed
unnecessarily in the early postpartum period? These factors could have set
the baby up for breast refusal or poor latching, leading to poor gaining
etc.
If the baby had been exclusively bf in a baby-friendly sort of way, and
presented at early checkup or by phone call for help, as having problems,
then YES it is likely the mom's anatomy is challenging. My recommendation
would be to try a nipple shield if usual latching on measures don't work.
Comp the baby with expressed milk by cup while continuing the help and
followup.
Experiment with various positions such as prone position and the (possibly
exaggerated) assymetrical latch to ensure good, full contact of tongue and
jaw on breast.
Hope this helps. Do keep us posted.
Laurie
Laurie Wheeler MN RN IBCLC
Mississippi USA

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