Dear colleagues. It's my first Lactnet post. I'm a pediatric nurse and
finishing my IBCLC course at UCSD Extension. I am struggling with personal
breastfeeding challenge that we have seen a pediatrician, 2 IBCLCs, ENT and
a speech therapist with no improvement, and the pain is getting worse and
worse. I'm in desperate need of advice, as I really don't want to give up
and I'm running out of ideas on what to do.

My son is currently 5 months old, was born at 37w5d at 5lbs14oz. Back to
birthweight at DOL 6, tongue-tie released at DOL21. Since he was born tiny,
his chin was small and receded, he had a hard time with a good deep latch,
and my large, pendulous breasts were not helping that. Right now at 5
months old and almost 14lbs, following his growth curve, however, still
unable to open his mouth wide enough to start and maintain a good, deep
latch. He's chomping on my nipples and clamping on them, I'm in pain with
every breastfeeding session and even pumping started to hurt (I'm a donor
mama, and donate 120-150oz/week). Pediatrician sent us to ENT, which
diagnosed my son with slight laryngomalacia and very enlarged adenoids, but
he said surgery would be the last resort and sent us to speech therapist to
help with breastfeeding issues. Speech therapist said the clamping and
chomping on the nipple might be caused by the fact that he's a mouth
breather and it's hard for him to breastfeed, especially when I have a
let-down but suggested no solutions on how to fix it. Other symptoms
include continuous wet breathing that sounds like his nose is stuffed, but
it is not (it’s the enlarged adenoids) and he pauses his breathing often
and moves on to mouth breathing. When taking a breast, he pulls away after
couple minutes, takes a breath, and we continue. He also can only extract
2.5-3.5oz from the breast each nursing session, and from the bottle with
slowest flow (Lansinoh Momma) easily takes 6oz. My son takes 2 bottles of
breastmilk a day, and seems to have no issues with breathing while taking a
bottle, and his breathing pattern is much better while eating from a
bottle, and quite terrible while eating from the breast (he pauses his
breathing for 3-5 seconds, gulps often even on an empty breast, has very
“wet” sounding breathing, and couple times a day chokes even when I don't
have a let -down or the breast have been pumped empty before a feed). My
nipples are red, cracked but only painful while feeding or pumping. We
tried elevated position for nursing with an IBCLC, but he just doesn't want
to take a breast this way. Other IBCLC suggested to visit a pediatric
chiropractor to help relax his jaw, however, I am not completely sold on
that idea. What are we missing? Is there anything else we can do? Thrush
has been ruled out as a cause of pain, and yesterday I had my first episode
of vasospasm while pumping and I believe it was because of all the nipple
trauma. I also moved to larger flanges for pumping. We tried and tried with
IBCLCs to help my son open his mouth more, but even chin pressure is not
working at all. I'm just so at loss, because I want to continue until at
least 1 year and never thought that I will experience all these issues that
no one seems to have an idea how to help with. I'm asking you, the
community of wonderful women who are great professionals, to help us. If
anyone has any ideas, please, I will be forever grateful! I’m located in
Riverside County, California.



Karolina Ochoa, RN, BSN

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951-901-5305

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