Dear friends,

I have mother's permission to post.
Mother presents with nipples that she considers to be "cracked"; I observed 
a significant, deep wound at least 2 inches long (about half the 
circumference of the base of her nipple) at the very base of the nipple that 
would open up in my estimation 1/8 to 1/4 of an inch (didn't have a tape 
measure, but she can basically peel the bulk of the end her nipple up and 
over the top part or her nipple that is not cracked and attached to her 
areola; like folding it over)  This wound is symmetric on both nipples, with 
varying stages of pain and healing between the two sides.  Baby has been 
audibly clicking since birth nearly 8 weeks ago; has good milk transfer and 
is gaining weight appropriately.  Baby feeds nearly constantly, however, I 
didn't observe any kind of tongue tie.  Baby does has tight labial frenulum 
combined with little actual lip tissue, <if that makes sense> which mother 
is trying to work with at this point.  We know baby has thrush and mother is 
now treating both of them for it. I suspect thrush has been lurking since 
baby was born due to antiboitics given during labor. I did not have a 
flashlight with me and didn't have good light to look at the palate.  :(
At a doctor's visit today, the ped confirmed that this baby does not have an 
epiglottis; rather, she has two small little buds of tissue.  Ped said it 
would not interfere with breastfeeding and that she may develop a more 
normal looking epiglottis over time.  ?????????????
Mother is using shells and feeling very much like they are helping; was 
reluctant to try a contact shield but is now thinking pumping for a few days 
could be ok and might help.  :)  Mother is committed to breastfeeding; had 
some of the cracking issues(I didn't see it was this bad, though) with her 
first baby that we worked through at that time, and she was fine after baby 
was around 3 months.
Are there studies or information I can share with her about any effect the 
epiglottis has on sucking/breastfeeding?
Are there other suggestions I can offer her?  She would prefer to breastfeed 
instead of pumping and cup feeding, but if this damage isn't corrected, I 
don't know how reasonable that is.
My apologies for this being so long,  Thank you so much for helping!

Warmly,
Tallis in windy NM 

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