Hi friends, I've missed lactnet but I have to admit that I'm back because I
need your help.

I am working with a client who has distinct nipple blanching.  Nipples are
pink and properly elongated when baby releases breast.  The blanching occurs
about 3 seconds later and lasts for about 3 seconds.

Baby was 4 days old at my first visit and Mom was having such severe pain that
she opted to stop letting him nurse and subsequently pumped and fed with bottle
or cup (mostly bottle).  She got treatment for nipple thrush and had
improvment.  Then she got bilateral mastitis and is now also being treated for
that and continuing to treat for thrush.  Both mom and her MD are very well
informed about lactation support.

Another LC in town told her that a vasospasm of the nipple could be the cause
of her pain but won't diagnose until she sees what is happening.  Deciding
who will pay is delaying this second consult, this town is tied up by HMO's
and clients need to self pay if outside of own HMO.

My second visit with family was on baby's 11th day.  Mom was back to nursing
occasionally.  Every time she tried nursing 4 times in a row she would end up
hurting so much that she would then avoid nursing for the next 4 feedings or
more.  I proposed a more gradual progression back to total nursing.

With some positioning improvement and timing improvement, we got baby to take
a better grasp on the nipple and mom had less discomfort with nursing.  As
we continued, his attachment got even better and she was completely comfortable.
BUT even then, balanching occurred as the nipple was released.  However, with
the improved latch on she was not experiencing the pain.

I think that this baby will gradually improve with practice, am I right?

Any other suggestions?

Please reply directly to me.   Thanks.
Ruth Sweet of Verona WI   <[log in to unmask]>