My daughter has long nipples, small babies at birth... first had tremendous difficulties which took months to get past, second took over 2 1/2 mo. before she could nurse without gagging.. daughter pumped as frequently as she was able to without getting frustrated, used breast compressions and took herbs to help with increasing supply (which worked very well)... babies just couldn't latch deeply enough to transfer milk well so they needed help getting what she had. Fortunately, with baby #2, they were able to get through the first months without too much trouble and she nurses happily now at 7 months.

I guess that I am of the mind, watching my daughter with both nursing relationships, that sometimes all the things we recommend become too much.. so, you're right, better, more frequent milk removal is necessary but sometimes those herbs do a bang up job of telling mom that they can do it... My daughter has also noticed that breast compressions while pumping are extremely effective at increasing her pumping volume and when I asked her to try hand expressing for a couple of minutes after pumping to see if that is also effective, she found that it was. Have had 2 moms do great with power pumping.. I always refer moms to Diana West's site starting with:

http://www.lowmilksupply.org/overview.shtml

Once they read how the breast works, most moms I've helped really get it and see what they are doing to help or hinder their efforts.. it is empowering!

kellymom.com also has an excellent page on how milk production happens.. it is more colorful :>)

I agree, baby needs to see the breast as happy times and growing into breastfeeding when it comes to long nipples, will happen with the growth of baby.

Did the labial frenulum get treated as well? Babies can still have trouble until labial frenulum is treated. Baby will have an opportunity to get the best seal and subsequently transfer milk more easily. Dr. Kostlow in Albany NY has info on his website. He does mention on the link below, that not being able to use the tongue properly does cause gagging so this may also be contributing to the problem. Some babies need to be treated more than once for lingual frenulum.

http://www.kiddsteeth.com/old_site/infantdentalcare2010.pdf

For some babies, every little bit of help is needed to make it work... other babies will nurse well no matter what the circumstances once the major obstacles are removed..... go figure.

Good thing this mom has you on her team.

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