Well for me the telling factor is her pain.  If she's in pain during
breastfeeding, then IMO something is wrong, no matter how good I think it
looks externally.  My bottom line to them is:  it's not supposed to hurt.
Therefore if it is, something's wrong that needs fixing.  In your example
(mom in pain, baby not gaining well) if all looks good from the outside -
baby's body is positioned correctly, baby's mouth seems well-latched - then
I suspect the baby is using his tongue incorrectly.  The presence of wounds,
cracks or stripes on the nipple would be very telling.

One of my own children (my third) was born sucking on his tongue - on one
side.  Never had I had sore nipples in my life until my third ripped one of
my nipples to shreds - talk about a humbling experience for the senior LLL
Leader in her group!  :::sigh:::  I was ready to throw that breast out the
nearest window; he's lucky he was my THIRD rather than my first.  I was able
to determine that on that side, he was lifting his tongue up prior to latch
on.  I taught him how to bring his tongue down, and by the time he was a
month old, he was nursing just as well there as he did on the other side.

My experience with WIC is that so many women supplement with ABM that I
don't see babies NOT gaining well.  By the time they call me, they're all
supplementing......
Regina Roig Lane, BS IBCLC for Miami-Dade County Florida WIC/Nutrition

> -----Original Message-----
> I'm learning a lot from these latch discussions. I think what makes a
> point
> in my mind is that for all the mums we see who seem to have a bad latch
> and
> yet everything is going well, there are all the mums on the other end of
> the curve who appear to have a good latch and things aren't going well at
> all. They are in pain, the baby isn't gaining well, and something is not
> right. I just don't have the experience to handle those situations, but
> how
> do you folks with the experience figure out what is going on in those
> situations?
>

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html