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From:
beth mcmillan <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 26 May 2013 10:31:48 -0400
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Hi All,

Going round and round in my head on this and I think I know what my answer to this mom will be but I told her I'd check in with this list to see if there is something else.......  Mom nursing 2nd baby, 6wks old girl, planned , repeat c-sec.  Challenges with sore nipples and clicking at first but pain resolved fairly well after mom saw IBCLCs at a drop-in clinics, know both, trust their work.  Recommendation was made re: frenectomy (tongue and lip) and procedure completed by our most knowledgeable practitioner (laser).  Mom states she was diligent with appropriate post procedure stretches.  Mom complains of baby still clicking and acting like she is 'gassy'.  Had a visit at home with me 10 days after release and sure enough baby was clicking, tongue losing grasp of breast - mom feels it flick her nipple - with most sucks, particularly w faster flow at 1st and 2nd letdown.  We played with positioning (truthfully, mom likes her comfy pillow! she'll sit back but practically I'm willing to bet she will go back to her pillow) but with little change.  I wanted to give it more of a chance but I don't think she will follow through.  There is absolutely NO chance of any bodywork at all.  Mom will not consider it.  I gave further examples of exercises/games to help strengthen the tongue muscles, baby's tongue is quite flat, not much cupping.  Gave support for getting much deeper latch, shaping the breast, etc.. and that might be the best thing I did but baby still clicked and flicked a bit.  I told mom I'd ask you all but that I knew the response would be bodywork and laid back positioning both of which realistically she isn't going to do.  I guess this is more of a question for me than for her......I wonder if there is anything else?? I thought about mom's supply which, while robust, isn't overwhelming at all (unless you don't have correct tongue movement...).  Baby gains appropriately, poops are normal, developmentally bang on.  I thought about submucosal cleft, baby generates vacuum.... she could also go back to the dentist who did the release and ask for reassessment re: further release (probably not going to happen tho, sorry sounds negative).  Mom is lovely and really is willing to do everything - except the things I think are most likely to help.  I guess what I want to know from you all is, can I be missing something else??  Oh, baby takes one bottle of pumped milk/day and clicks like mad on that bottle nipple too.  I think time will help somewhat, but anything else??

thanks 

Beth

Beth McMillan BA IBCLC, RLC
Ottawa, Ontario, Canada
www.bethmcmillanibclc.com

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