Melanie

This may be too simple.  But is mom supporting the left breast during
breastfeeding?  She could be holding the baby just a little too high, so
that weight of the breast causes baby to lose suction with each suck
(sometimes you can see pulling or stretching of the skin near the areola in
and out of the baby's mouth with each suck?  Or, if the breast is slightly
fuller, as you say, perhaps it is just not so "compressible" as the right
breast.  Have mom cup the back of the breast underneath, near her ribs, in
line with the baby's smile, and lift the rounded underside of the breast to
flatten it somewhat, as if she is "pouring" this breast into the baby's
mouth - just to take the weight of it off the baby's lower jaw.  Sometimes
it only needs one finger, rather than all of the fingers to cup.  She
mustn't lift the breast *too* much, or it will cause baby to "lose" the
nipple from the opposite direction.  Maybe have her experiment a little
with lifting the breast just a little, then a little bit more until it
feels and sounds right.  I sometimes describe the areola like a flower and
the nipple like a stalk, and try to show the mom that the stalk needs to be
poured straight down the baby's through, not too high, not too low, and not
off-centre to one side or the other.  Here's where two seconds of
observation would be worth a thousand words ....  Sometimes I used to have
the mom attach the baby in the normal way, and then just use *my* finger to
lift/straighten the underside of the breast to achieve a deeper latch.  It
can help too if mom expresses a drop of milk before latching, and wets the
whole areola with it, to make it slippery, so that as the baby takes that
first "suck" more tissue goes to the back of the throat.

The main message seems to be that the latch needs to be deeper.  On the
other hand, some moms and babies don't mind clicking, and if it's not
causing a problem for either of them, I don't believe it needs to be
"fixed", even though it's excrutiating for the LC to hear!

Hope this helps.

Pamela Morrison, IBCLC, Australia

At 01:29 AM 22/10/04, you wrote:
>Date:    Thu, 21 Oct 2004 10:01:48 -0500
>From:    "Sheppard, Mellanie L" <[log in to unmask]>
>Subject: 12wk old Baby Suddenly Losing suction at Breast
>
>When it rains, it pours.  It seems God is keeping me humble with my new
>IBCLC status by sending cases my way that I have no experience with.  I am
>so thankful for Lactnet.
>
>A mom in my support group has a 12-week baby who was nursing fine until
>about 3-4wks ago.  Baby now "clicks" and loses suction, but only on the left
>breast.  Nipples are normal, although the left nipple is slightly smaller
>than the right.  Mom had piercings in both nipples that are now healed.  Mom
>reports that supply in left breast was lower, but she noticed about 4-5
>weeks ago that supply now seems to be greater in that breast.  She says it
>feels fuller and she gets more milk on that side when she pumps.  When she
>first told me about the problem, my first thought was over-active letdown
>and the baby was compensating, but after I watched her nurse I don't think
>that is the problem.  Baby clicks throughout entire feeding on the left,
>frequently loses suction and has to reattach.  Mom is feeling sore and raw
>due to all of the popping on and off.  Baby is gaining well and does not
>seem to be in distress during feedings.  Baby does have some white residue
>on her tongue, but mom says it has been there pretty much since birth and
>there are no other signs of thrush.  I suggested that the mom try nursing
>the baby in the same position on the left that she uses on the right (i.e.
>latch baby on right in cradle hold and then just slide baby over to the
>left) to see if that makes any difference.  Any thoughts as to what could be
>causing this?
>
>Mellanie Sheppard, IBCLC
>Lactation Connection
>Arlington, TX USA

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