Hi everyone,
  It's been so long since I've posted anything that 75% of
you don't know who I am, so here's a brief profil before I
throw out my questions for today.  I am an IBCLC, ICCE, and
an LLL leader...oh yes, and mother of 3 wonderful children.
I am in private practice in a very distant Chicago suburb.
  I have 2 rather interesting cases for you.  The first one
is a mom whom I saw 2 weeks ago.  At that time, baby was 3
1/2 weeks old, and mom's nipples were the worst I've ever
seen.  Honest to goodness folks, there were chunks of nipple
missing.  The entire tip of her nipples looked like mucous
membranes rather than external skin.  I helped her to nurse
the baby in football hold, and all of the areola was in
baby's mouth.  Digital suck exam was normal.  Due to the
terrible condition of the nipples, I suggested that she pump
to give them a chance to heal.  It's been 2 weeks now, and
she is still in dreadful pain when she puts baby to breast.
Any suggestions?
  Case #2:  Mom bottle-fed her first baby and was planning
to bottle-feed this one, but after going through 3 ABMs
in the first 2 weeks, she decided to give bfing a try.  Baby
is now 2 1/2 months old, and has continued to get fussier
and fussier at breast.  He pops off the breast several times
in a single minute.  His frenulum is attached at the middle
of the tongue.  The ped said it should be clipped, but the
surgeon wouldn't do it because he said it was WNL.  Baby can
stick out his tongue and does cup breast appropriately
during nursing.  Mom does not have sore nipples.  Mom is
continuing to supplement with one of the soy ABMs that baby
exhibited an allergic reaction to, saying that one bottle a
day doesn't seem to bother him.  I suggested that she cut
dairy out of her diet for 2 weeks and also d/c the ABM.
Perhaps baby's fussiness is due to allergy?  Any
suggestions?
  I'm glad to have access to this service.  Looking forward
to everyone's 2 cents!
                                 Debby Boehle, IBCLC