I just had a mom in for a visit complaining of nipple soreness. The baby has
just turned 4 weeks old a few days ago. The kicker in this is that the mom
had been to see a number of people, ranging from the public health unit
nurses, her family doctor (who is one of the best in the city for
breastfeeding support), and a LLL leader, all of whom gave her varying
degrees of "Relax, in a few weeks the pain will go away." So, after being
urged by her mom and husband, she came to see me. (I was her doula and her
childbirth educator.)
I took a look at the latch, which looked good and began asking questions.
After a bit of time, I came up with three issues: a dislocated jaw, mild
vasospasm and a slightly short frenulum. Talk about a mixed bag of
problems... I felt like I had to be nuts coming up with such a hefty list of
problems.
About the only thing within my scope was the vasospasm, so we talked about
some ways to deal with that. After that, I suggested a trip to the
chiropractor and to a local IBCLC who is also a doctor.
So, off she went to the chiropractor who disagreed that the jaw was
dislocated; instead, she said the entire occiput was lopsided. The
chiropractor told me today that babies who are born asynclitic, as this
little one was, often end up with problems presenting about 2 - 3 weeks
after birth, meaning that the clicking presented itself pretty much en par.
For this baby, I could actually *feel* a clicking when she nursed by putting
my hand on her cheek on her the mom's breast, but since the latch was
perfect on the outside, and since the clicking could only be felt when the
baby nursed on one side, I took an educated guess that this was a jaw
problem. Thankfully, the mom was already seeing a chiropractor, so the
suggestion that the baby get looked at was taken easily.
As for the vasospasm, it was a pretty classic look with all the classic
symptoms. No major surprise there.
The only thing I'm not entirely positive I did ok on was the frenulum.
Regrettably, I don't have the same rapport with the doctor-IBCLC as I do
with this particular chiropractor... actually, it's the first time I've ever
had to refer out to anyone else. The mom won't see the IBCLC until tomorrow
at some point and even then, I won't know what went on unless the mom tells
me.
By luck, I took a photo of the baby moments after she was born. I just
scanned the photo and uploaded it to a page:
http://www.birth.bc.ca/birth/breastfeeding/frenulum.htm
I'd really appreciate some feedback on this baby. Is that a short frenulum
or did I jump the gun on this? Sorry that the photo is quite small, but I
cropped it to get to the tongue.
Thanks!
Charlotte Millington
Maternity Photographer, CLD, CBE, Doula Trainer (CAPPA)
Visit www.birth.bc.ca for more information on BC childbirth.
CAPPA Regional Representative for Western Canada Visit www.cappacanada.com
for more information on doula training in BC.
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