I am so excited to read through all of the information in these postings! It looks like after I read through the postings and organize all of your fabulous thoughts and ideas mom will have a great tool box of tools this time around.
Her nipples do evert very well after pumping, and there is was only pain noted on the right side with a deep latch during the 2 times she was able to latch infant briefly with my assistance, no pain while pumping. So, things are looking up! Initially I think the plan to present to mom is going to be supple cups, rps, cup feeding, pumping and hand expression for eversion, and ridging breast. The more I think about it and read the postings the more I learn and the more I am convinced that the first child was not able to latch not just because of the age and the all too distractable 3-4 month old behavior kicking in but also because of initial nipple shield use at birth with possible improper latch and suck changes with bottle use after infant was home.
On a side note: In the Vegas area I am now seeing with much frequency moms sent home with nipple shields due to overly swollen breasts from fluid from c/s (our rates of c/s are really really high and the incidence of a baby being separated from mom post c/s is still very common) not taught how to bring infant to a deep latch on nipple shield from the first latch, assess latch, provide breast compression to assist milk to infant if needed, assess for 'eating sucks', and lots and lots of nipple sucking on the shield without mom knowing it because of the shield and then wondering why nipple is sore. I have seen on multiple occasions now square to flat shaped nipples post feed after using the nipple shields from this.
In any case, this then seems to be translating to a nipple shield infant who knows how to slide himself to a latch that may or may not be deep and concerns for weight gain arising...which when corrected with open gape latch, compression, and latch assessment equals weight gain and a happier dyad. Then the nipple shield weaning trick becomes teaching infant how to open gape latch deeply directly onto a breast which feels completely different from a nipple shield. Again, this is my current observation in this community but now having seen it in more than a few moms I am concerned more and more. I am a NICU RN so I love nipple shields for preemies, emergency c/s and swollen breasts, and as a tool to get baby to breast no matter what...but education when using them seems to be lacking in this community. Ok, I am off topic now...sorry.
Thank you again for all of your suggestions and hopefully I will have positive news of a vag. twin term delivery in October and latching happy healthy babies.
A Very Grateful Thanks,
Lisa Weinshenker, RN, IBCLC
Las Vegas, NV
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