Hello Everyone!  

Permission to post: I run a group which is more like a support group, although I am an IBCLC.  The mother about whom I have a question is a first time mom, originally seen by me when her  baby was about 2 weeks old - 2 weeks ago.  Her baby was born at 7lbs 6oz, lost about a pound, and had not yet gained back birth weight when she came to the group.  When she went to feed, her full, med-size breasts were freely dripping (even running) milk onto her jeans. To me the baby appeared skinny and hungry.  I told her, as did several mothers there, that she had a great milk supply.  I had the opportunity to mention that the baby may be struggling with oversupply and that she may want to feed from one side per feeding and to watch for stool and urine, etc., and to see her pediatrician soon.

At that time the mother's nipples looked terribly red and irritated and she complained of blisters (which were not apparent to me) and tremendous pain not only on latch but throughout the feed as well as if any "air" touched her nipples.  She had been to a pediatric dentist at the recommendation of her hospital-based IBCLC, and the pedi dentist ruled out tongue and lip tie.  Generally, I do not look for TT during the group sessions, so I just took the dentist's word for it.

I saw her again yesterday and the nipples were just as bad.  She reported that the baby had gained up to 8lbs 4oz.  The baby still appeared hungry to me. 
Last night she texted me that the baby is now "chomping" on the nipples and not maintaining suction.  I recommended a full assessment with one of our private practice IBCLCs and gave her permission to give EBM via bottle.  I also mentioned CST (and I privately wonder if there may be a tongue tie, but have not checked due to the nature of our groups>)

Thoughts?
Ljberk in El paso

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