Why would a 2-month-old baby still be feeding in a way that causes blisters
on the tips of mom's nipples (now gone to cracks and bleeding)? Baby is
gaining a lot of weight.

I was called at the newborn period because of sore nipples. Follow-up call
indicated that all was resolved, only to hear 3 weeks later that the
soreness had persisted.  We worked on latch again and all seemed well.
Then I was called at 7 weeks to hear that mom's nipples had blisters and
had been in great pain since soon after my prior visit. Baby had been
having green stools for several weeks and was very fussy at feedings and
after.  Watching a feeding, I saw signs of oversupply. I recommended steps
to resolve the supply problem, assuming that baby was protecting airways
with her tongue, hence damaging mom's nipples. Changing position to the
side hold helped some but baby didn't like the position.

When I called a few days later, mom said that the baby wasn't choking at
the breast any more, and that her nipples were still sore, but getting
better.  Stools became yellow, but baby was still fussing a lot, sometimes
crying a lot in the evening.  So I pursued diet as a factor. Mom is very
reluctant to consider diet.  She is vegan, so we don't have dairy to
consider, but I talked about soy. She didn't make changes to her diet.

I am wondering if, during the oversupply period (at least 3 weeks), baby
developed a suckling pattern that she is reluctant to give up even though
the supply is down now. The frenulum seems ok.

Yesterday the call revealed the damage to the nipples. Baby is 8 weeks now.

What am I missing?  I have considered yeast but parents won't hear of it.
(Actually they are resistant to most of my observations and suggestions.) I
will gladly accept suggestions that seem obvious, because "obviously" I am
missing something here.  I feel like a novice LC who doesn't know what
she's doing.

You may wonder why she waits so long to call for help.  So do I wonder.
Dad suggests that she call me, but she refuses, so he makes the call.  She
will say that she has to hold baby all of the time or she cries, then says
that baby isn't fussy. She will speak of her being cranky, then when I talk
about what "cranky" can mean, she says that she isn't cranky. She is most
resistant to help for some reason.  Well, this isn't the cause of the sore
nipples, just a cause of frustration for the LC.

So, what do you think?

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA
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