Hi Yasmeen,

I don't remember the details of all the cases, but seeing Case 3
pictures, it seems this mother has quite large nipples, to me. They
sort of look bruised to me around where the nipple joins the areola. I
don't even remember if this is an older infant, but I think this could
be a physical injury rather than an infection. Mother should really
attend to a deep latch, and if she does any pumping, ensuring a large
enough flange size.

Case 2 I'm still thinking some type of airway issue or just baby
needing to be in control of position, pacing of feed. Hopefully that
baby will take to breast again with lots of STS and as baby matures.

Case 1 I'll admit I do not have experience with bodywork practitioners
but I'm just echoing what many lactnetters say about bodywork being a
big help. As to how to assess supply there are several ways. One is to
just palpate her breasts, hand express; I usually have a feel for how
full, how easily a mom can release milk. There are pre/post feed
weights, and then if mom will express that gives you an idea too. I
think you said the baby was very fussy, that is a common sign of
hunger. You say mom has a slow letdown that can mean a lower than
needed supply.

Wish there was a quick solution to all of these, but that isn't so.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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