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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 13 Jan 1996 18:06:37 -0500
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Jay,
IMHO, any mother with nipple soreness should be referred to an LC.  Soreness
is one of the red flags.  If you are confident that you can work on
positioning and latch on over the phone, and that immediately resolves the
situation, great.  But this kind of work usually is more effective in person.
How exactly is your role defined by WIC?  Here peer counselors provide
breastfeeding information, emotional support, encouragement, and referrals in
the event of difficulties. That is a big job in and of itself.  To ask you to
diagnose nipple soreness over the phone is a lot to expect.
        But, to answer your question, I usually ask:
when does it hurt? (latch only, during entire feed, between feeds)
is there visible damage?
what does the pain feel like?
how old is the baby?
when did the pain start? (from birth is usually a latch or suckling problem,
recent onset in older baby could be thrush or new teeth, especially in a
tongue tied baby)
have mom or baby taken antibiotics?
does baby open wide and stick his/her tongue out over the gums before latching
on?  (the answer should be yes)
are your shoving the breast into the baby's mouth? (the answer should be no).
That's only a few of them.  The answers usually give me an idea of where to
look first, I don't make up my mind until I see the dyad.
Catherine Watson Genna, IBCLC   NYC   [log in to unmask]

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