Just a thought…

Baby is tongue tied (so mom says)
Non sore breast has very fast let down (so mom says)
Breast with regular flow has painful nipple

Could it be that the baby doesn't really have to latch properly on the left (strong) side, so the tongue has minimal contact with the breast?  If the baby doesn't have to milk the breast to get milk, then there would be minimal tissue damage.

If the right side has a normal milk flow it is possible that the baby needs to use the tongue/jaw in such a way to get the milk out that the baby is causing soreness/bruising (you may not actually see the bruising) due to the way the baby is compensating for the lack of normal tongue movement.

It would be interesting to see how the baby's weight gain is doing, and to see if the baby's weight starts to drop off over the next month or so.  In my experience, in some mother-baby pairs, if the tongue tie isn't released early on, there can be milk supply issues around the 4 month mark when the body is switching to more of a supply and demand method of milk production.  If the mother started off with over supply in the early weeks/months (baby living off of letdown but not actively milking the breast) her supply can radically drop off when her nipples aren't getting the appropriate suckling feedback to maintain her supply.

Just something to think about.

Tania

Tania Archbold B.Sc, IBCLC, LLLC leader
Mothers Nectar Lactation Consultant Services
519-400-7098
Guelph, ON, Canada



On 2013-04-09, at 1:23 PM, Lisa Paul <[log in to unmask]> wrote:

> I have permission to post.  I need the group's wisdom on this.  
> 
> "My daughter is almost 4 months already and breastfeeding has been going good and even though she is tongue tied she still does great! Anyways i have normal protruding nipples and my left side does great when she eats its like someone turned on a shower it will just spray out and i never have any pain or anything on that side and i never have, but my right side is painful every time she eats and always has been and it does not flow out like my left side does. But she does get milk and she is satisfied just like she is on the left side. Its like i cannot wait for her to be done eating, it seems to me like the pain is coming from the bottom of my nipple and it will ache even after she is done eating. I have no lumps, swollen areas, pus, bleeding or cracks or anything it looks and feels normal it is just painful. For a long time i just thought it was the normal soreness of bf but now that it has been 4 months i realize it must be something else. It is obviously not something i cant deal with i would just like to know why it is painful and if i can fix it, either way i am not going to stop breastfeeding.."
> 
> Immediately I thought past breast trauma, or potential thrush (although the one sided aspect made me think not.)  I considered Raynaud's but again the one-sided aspect.  I wonder if the tongue tie could be playing a role, but I don't want to get focused on a non-issue.
> 
> I have not met with this mom in person yet - and honestly what she is self-reporting, I doubt I would see anything or what to look for.   She also doesn't have any recollections of breast trauma in her past nor has she noticed any itchiness of the nipples.  
> 
> I am not even sure what questions to ask...I just keep asking myself - what would cause pain like this and what would make it go away?
> 
> Thank you for any direction/questions/thoughts you all may have!
> Lisa Paul
> 2013 IBCLC Candidate
> 
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