My neighbor has developed a nasty nipple crack and I'm at a loss as to how
to help her.  The baby was born April 6, a week late, male, 7 lbs 8 oz and
had been nursing well; however, she has a history of reporting that her
milk "goes away" at 3-5 months or the baby "doesn't want to nurse" at
around that time. (She has 3 older children, 7, 4, and 3). So with this
problem coming so soon I'm worried about this bf relationship much earlier
than I thought I would have to be. I also didn't think she'd come to me for
help, as she isn't the type to do that. But she has, and I don't get the
impression that my advice has been of much help. It still hurts and isn't
getting any better.

The crack is on the right nipple, her "big producer." She reports that her
left breast never produced much, and on observation it is noticeably
smaller than the right breast. The latch looked good when I saw them on
Thursday; this child could suck chrome off a bumper, and perhaps that's the
problem. She has been using a small hand-pump to pump the affected breast
and reports that this doesn't hurt; her sister is loaning a larger electric
pump. She has been feeding the expressed milk in a bottle. I advised her to
use a cup or syringe but I don't have much experience at teaching how to do
this (none at all, actually) so I couldn't advise her on exactly how to do
that. She says she doesn't want to go to formula but may have to since her
left breast production combined with the milk pumped from the right are
barely keeping up with the baby's demand.

I mentioned the possibility of thrush but she appeared reluctant to go in
to have that checked, as the baby has no symptoms. Her next appt. isn't
until the 28th.

I feel so knowledgeable some days, but with things like this I'm hopeless.

Nancy Kramer
P.S. Met with my Korean client today and she's doing GREAT. Baby is
GORGEOUS. Now to convince the father of this!