Permission to post from mother - long.

I initially saw mother and infant in the hospital when mother was complaining of pain when nursing. Helped corrected latch and pain went away. They were discharged that day. Mother called about 4 days later with pain when nursing. When i saw them the latch was corrected again. I noticed that infant was gumming saw and pretty sure he had a posterior or submucosal tight frenulum. Infant was also loosing weight. I talked with parents about the frenulum both mother and father were unsure what to do at that time. I provied mother with a hospital grade pump to increase milk supply and had them come back the following day for a weigth check for the infant. At next appointment infant still had lost weight (about 100 grams). Instructed parents to supplement with SNS. Mother c/o significant pain with nursing even though latch appeared better. Parents discussed getting frenulum evaluated but wasn't exactly sure if they wanted to do it or not. Mothers nipples had small amount of abrasions on them, she also had significant clogged milk ducts. Mother decided at that time that she couldn't bring infant to the breast because of the pain so she decided to pump. Spoke with parents a few days later and mother had decided to pump she also said that she was being treated for mastitis at that time. Mother called back about 2 weeks later - they decided to do the referral for the PTT and stated that her medication was gone but she still had soreness on the breast. I instructed her to call her OB back again. I just saw the couple again last week. At this time infant had just had referral and was told by ENT that there wasn't anything there that he could clip that would make a difference. I did notice at this visit that infant had slightly more movement of his tongue we attempted nursing but mother. Small amount of pain for the first 10 minutes but then it started to pick up and mother had to stop nursing after 20 minutes. Assessment of mothers breast showed bilateraly redness (hard to describe - the entire underside of area of the breast had red spots, the breast was red and then there was red spots on top of it which varied in color from light pink to dark red and even some i would call very light pink) the nipple and areola looked almost normal, one nipple had one small area that was still healing). Mother informed me that when she had taken 2 full courses of keflex and was perscribed liquid nystatin to place on the underside of her breast but she stopped using it because it was very sticky. The breast felt full but there wasn't any areas of clogged milk ducts, mother has not changed soap or detergent, was not using anything on the breast, not using underwire, although she did say that she leaked a lot. 
Due to some recent conversations on here i mentioned the use of cocunut oil as i tried to get some insight from other wiser LC's. Any thoughts or suggestions - please

Jessica IBCLC
USA, NC

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