Any opinions on this would be greatly appreciated. I am open to suggestions.

I have a mom I am working with. Baby is 6 weeks old.  Ineffective  nurser. I
have worked with her twice, working on latch extensively. He is better, but
still just hangs there if there is no compression or flow. He is 7 - 13.
Birth weight 6-2. Mother has extremely painful nipple/breast on right side.
Left side is tolerable, though tender. Right side is 8 out of 10 on the pain
level. She is on the four part ointment that Jack recommends containing
antifungals, antibacterial and corticosteroid, and on 200 mg diflucan po qd
without much relief. No signs of tongue tie, Raynauds. She has compression
vertical stripe on nipple despite best effort at positioning.  Had vaginal
yeast symptoms, which have abated.

Baby takes 1 hour for feedings at breast.  He just hangs there, doing
nothing most of the time. Did not break into nutritive sucking pattern today
despite breast compression.

She pumps four or five times a day, and at this point, gives him a bottle of
supplement. Uses about 10-12 ounces of supplement per day, half
breastmilk/half Sim20. When fed enough, he sleeps a lot. He is just plain
ineffective on breast.

Any ideas?

What next for the pain? The stripe? what am I missing? reply to list and to
me privately please.

Thank you.

Kathleen

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont
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