I am a birth and postpartum doula but a recent client's situation has me stumped. G1P1 woman gave birth to a boy, 7# even, at 40wks exactly, vaginal, no complications, epidural @ complete dilation, pushed for 1.5 hours, only had 2 bags of IV fluids, did have 5 hours of Pit after SROM w/ no ctx. I helped with baby's first contact at breast - made hunger cues at about 45 minutes old - lip smacking, tongue thrusting, etc. Baby very alert for the following hour. Mother has very large areolas (7-8cm), tiny nipple that everts only slightly - somewhat large breasts. Brings baby to breast and he opens very wide to latch, but won't suck. Tried several different positions albeit with 'helpful' nurse looming over our shoulder wondering if he'd latched 'yet!' Hand expressed drops of colostrum onto nipple and he eagerly licked off but would not latch and suck. The colostrum is plentiful and very easily expressed - totalled about 15-20 drops between both breasts in about 30 minutes. He looked rather satisfied afterward too. The nurse was baffled at how to chart 'licked 15-20 drops of colostrum off breast...' In the following days, he still hasn't latched on well, but weight loss has been minimal. At home on Day 3, breasts are VERY full, palpate milk in both, but nipple is now flattened out and baby just won't latch, despite help with positioning. Helpful neighbor brought client a pump and SNS which has worked for now. I have strongly suggested she consult with an LC, but she feels she can just pump and use SNS (with EBM) at breast until his mouth grows :(. He gets very frustrated with trying to latch on and trying different positions and holds of the breast to help him grasp as much of the areola as possible. As mom says, "he just knows it's not going to fit and he's trying to tell us." When we did hand expression (both immediately pp and just this afternoon) I noticed the most milk squirts out when we're pretty far back on the areola. This baby's mouth is so tiny, I can't see him getting enough breast in his mouth to compress the milk sinuses. I just know a more experienced person (an IBCLC) could figure out a solution to this issue of mom's large areola and baby's tiny mouth. Any ideas? I tried searching LactNet already but "small mouth" and "baby won't suck" didn't yield any results. TIA! Lanell _______________________________________ Lanell Coultas - CD (DONA) DONA State Representative - TEXAS Birth & Postpartum Doula Care (512) 459-3088 * Austin, TX http://www.lanellcoultas.com _______________________________________ "Ask the woman; she will tell you everything you need to know." -Ina May Gaskin *********************************************** 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