There was a mom in my breastfeeding room this week who met me with big blue
eyes full of tears.  Her baby had lost nearly 10% of his birth weight, and
she was worried that she would be forced to give bottles.
Primip,normal,uneventful birth. Baby put to breast in the delivery room.
Full rooming-in.  Feeding regularly the day after.
 Her positioning was picture-perfect, great latch, no pain, baby calm at
breast.  Suck-swallow seemed a bit fast, but given the baby's serenity, this
did not seem problematic. ( Of course on day 2 you do not hear the swallow,
but you "see" it.)
I told her to call me when he came off the breast, but she said that he
never comes off the breast.  OK, they all are attached endlessly on day 2.
I just wanted to get a look at his tongue in case there was a frenulum
issue, because Dr Botser, the doc who clips the frenula was on his way out,
and I didn't want to miss him.  The truth is that the way the baby moved his
mouth on the breast, I doubted that the frenulum was the problem, but I had
to check out everything.
Nothing unusual in the baby's mouth.
Then I took a look at the mom's breast and nipples.  NO, they were not those
huge long nipples that prevent the baby from getting to the areola.  I had
about 7 of those last week ( isn't it funny how they come in
waves.........suddenly a day of long deceptive nipples, and babies nipple
feeding not breastfeeding?(
No, on the mom's areola on either side of the nipple were what looked like
parentheses, scars from plastic surgery.  It looked like this: (o).  What
was the story? She had very inverted nipples, as did her mom and sister.
Ten years ago she had plastic surgery to correct it, and now she has
protruding nipples, but when I tried to hand express a little milk, there
was not even a drop.
Could there be corrective surgery to reconnect the ducts? Have any of you
encountered this problem?
I set her up with an SNS, and 2 days later I managed to express one drop on
milk from the lower part of the nipple, but there was no way this baby would
be able to get enough milk from his mom.
I still do not understand how this baby was so happily feeding for 2 days,
and even after he got bottles until the mom was comfortable with the SNS, he
was very happy to return to this breast which had really not given him any
nourishment.
Breastfeeding is soooo much more than food.

Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel

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