Hi Traci!
Sometimes it can LOOK as if a baby is latched correctly, BUT THE NIPPLES
TELL A STORY when the baby comes off:
Although the baby may be latching on correctly, I think the POSITION of the
baby on the breast is slightly off balance here and thus the mirror image of
ulcers at the 11:00 and 1:00 positions. I have found that this is often due
to baby being held too far over to the side of where the ulcers or lines
are... This often happens when the nipple is aimed more at baby's tongue as
baby latches, and not aimed to the top-back of baby's palate. Is the mom
holding baby's head in the CROOK of her arm? Then this would happen. Baby's
head should rather rest on forearm and not in the crook. (or mom could hold
baby from behind the neck with opposite arm...)
Ask the mom to do the following:
- Before she even latches baby, get comfortable and sit up straight - all
pillows ready, etc.
- Then hold baby tummy to tummy - with baby's groin tucked in as close to
mom as possible. (asymetric latching)
- Next ask mom to look at where baby's mouth is at. Baby must just be able
to kiss the nipple - she needs to move BABY till baby's mouth is right
there. If baby's head is held in the crook of her arm, you'll find that the
mouth will be further over and mom would have to press the breast to get to
baby. This is wrong. You move baby to EXACTLY the right spot (just able to
kiss nipple) before latching even starts.
- Only then - tickle baby's lips till he/she opens wide - and here you'll
find that the nipple is aiming to the top back of baby's palate and the
lower lip is on the outer edge of the areola. (This is very important!!)
- Then bring baby onto breast very fast till the corners of the baby's mouth
touch the breast to form the seal.
- Also get mom to make a 'sandwich' with the breast that helps baby to get
onto the breast more deeply - but moms fingers should be well away from the
areola (I'm sure you know most of this! :)
- For the pain: It really helps to get the let-down going BEFORE latching
(by stroking the areola gently till the milk flows)
- Look at nipples again when baby comes off. If there is a ridge to the one
side, baby was too far over that way. If the ridge is right in the centre of
the nipple, baby is in the right place, just not latched deeply enough yet.
For a perfect latch there should be no ridge to any side of the nipple, and
not even on the centre of the nipple, and the nipple should be well rounded
when baby comes off, then all is well! This may take some practice so lots
of patience... Tell mom that even though breastfeeding is natural, it is
also an ART to be learnt :) She'll get there.
I learned all this personally the hard way as my 3rd baby had the latching
problem when everyone else thought he was latched fine! Then I read a book
called "Bestfeeding - getting breastfeeding right for you" by Mary Renfrew,
Chloe Fisher and Suzanne Arms, and that saved the day! (I fed him for the
first time without pain when he was 4 months old due to this latching
problem!!!! And before I had him I thought I 'knew it all' when it came to
breastfeeding!! LOL)
That book is now my Bible when it comes to teaching mothers how to latch
correctly.
Let me know if this helps and how it goes?
All the best!
Yulanda Ridge
LC and mother of 3 in their tweens
(temporarily using my hubby's PC as mine is giving problems...)
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]]On Behalf Of Traci Mills
Sent: Tuesday, September 13, 2005 5:24 PM
To: [log in to unmask]
Subject: new here - need suggestions (long)
Hello All!
My name is Traci and I have been an LC for 5 years. I
have just recently started a private practice in
Wichita Falls, Tx.
I have a client that has serious ulcers on both
nipples, and has given permission for me to post to
the group. Her nipples look like mirror images of each
other. The ulcer on the right side is at the 11:00
position, and the one on the left side is at the 1:00
position. Baby is 4 weeks old, and a little barracuda.
His bottom lip flanges, but I cannot see the tongue,
and his top lip tends to roll under and mom will pull
it out.
The left nipple is healing slowly. The ulcerated area
is bright red and the new tissue looks very healthy.
The right side is a yellowish color. This one
developed just in the last few days.
She also has deep fissures across each niple.
I observed several attempts at nursing. Mom has good
positioning, baby has very audible swallow, and is
very alert. White compression stripe is apparent when
baby lets go of nipple.
As I looked at mom's nipples, something just didn't
seem right to me. Her areolas seem way to round, like
the end of a watermelon. She has a tiny stump of a
nipple, and stated she's never had "perky" nipples
like you'd see on models. So, I am suspecting flat
nipples, and baby has pulled them out a little from
nursing. Mom said no one ever looked at her nipples at
any time.
Baby is gaining weight, (7.1 at birth, now 9 lbs). Mom
leaks lots of milk, but she is in so much pain she's
ready to give up. So far she's still 110% committed to
breastfeeding.
She's using Lansinoh, and has just purchased a nipple
shell she began using yesterday. I showed her
different positions, but all are painful. I suggested
she pump after feedings and cup feed baby when he
first wakes to stave off hunger so she can take some
time getting him positioned. He seems to sleep through
early hunger cues. I am open to any suggestions to
tell mom how to nurse comfortably. Of course, pain and
injured nipples are first concern.
Thank you so much for any sugestions.
Traci Roberts Mills
MotherNurture Lactation Services
__________________________________
Yahoo! Mail - PC Magazine Editors' Choice 2005
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