Hello Jean and Lactnetters-
Thanks in advance for your help, and please respond to me personally as I
am nomail for now.
My very old and dear friend who is a home birth midwife with some 20
years experience had a baby last week. Normal term boy, went to the
hospital for some pitocin after protracted labor at home. Delivered
without pain meds, home the next morning. 8lb 9oz birth weight. No
yeast infection in pregnancy.
I went up the next day to cook and help with house chores for a couple
days.. Baby's latch looks fine, and we were hearing big swallows from
very early on. However, when baby comes off the breast, mom's nipple is
deformed into a wedge shape at the tip -- what some lactnetters have
called a "lipstick latch" in the past. Within 2 days, she had stripes
across both nipple tips, despite best efforts on her part and mine to
optimize latch. Baby's tongue extends past the gumline, although it is a
bit short, and has a dimpled, slightly heart-shaped tip. Nipples are
large, breast tissue is stretchy but somewhat thick around areolae. A
big mouthful, but baby looks great when observed at breast, very nice
wide latch. Suck exam is normal.
By the time I went home last Friday eve, mom was developing fissures
around the base of one nipple, and decided she wanted to use a nipple
shield to mitigate pain during feeds. Her idea, not mine. I observed
1-2 feeds with the shield, and latch looked about the same as it had
without a shield, that is, fine. mom initially reported much better
comfort during feeds with the shield. We have had close phone contact
since I went home, and it seemed like things were on an upward trend.
She was nursing on her better nipple without the shield.
Today, things are worse. Both nipples have fissures around the base
(stripes across nipple tips are healing). Feeding is painful even with
the shield, and mom notes nipples are still wedge-shaped after baby comes
off. Also she weighed baby Saturday and today, and he has lost 2 oz.
(milk was coming in when I left Friday, mom reports highest fullness
Sunday). We are considering a couple days of pumping to let her nipples
heal.
Obviously, this is a latch problem, but with >10 years experience as an
LC, I am stumped. Please help.
Thanks much to all--
Martha Johnson RN IBCLC
EUGENE OREGON USA
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