I share the frustration of all of you who are tired of moms being told that
their latch "looks" fine when mom is in so much pain.  I tell these mothers
that it is not how the latch looks that defines a good latch, but rather
that the definition of a good latch is one that is both comfortable and
effective (good milk transfer).

 

I just this week had an extreme example of this: mom complaining of nipple
pain and difficulty with latch in hospital; seen by 8 nurses, 2 or 3 LCs and
2 pediatricians in hospital; told by all who "looked at latch" that latch
was fine; and at discharge when baby was 36 hours old and mom reported that
baby's mouth seemed dry, was told, "oh, that's different" and nothing else!
(This is mom's report the next day when I saw her.) Baby nursed "non-stop"
at home on day of discharge, then refused to nurse all night, was agitated
and in distress, no sleeping. At 8 AM they began expressing colostrum and
spoon feeding, with sks, until I could see them that afternoon.  As soon as
I took baby to weigh him I saw a classic tongue-tie.  At >72 hours old he
had lost more than 10% of birth weight and was dry, no stools since 25
hours, scant pee with lots of urate crystals.  I was able to help mom get
him latched to both breasts, but he only transferred 4 ml on right and 8 ml
on left even though milk volume was increasing; mom could not repeat even
this at home, so went home pumping and fingerfeeding until frenulum was
clipped the next day and after until he finally began latching and
transferring milk well last night at 6 days old. Because he was seen in
hospital by staff pediatricians, his own ped had not planned to see him
until 2 weeks; even with the report of the problems going on, ped did not
see him until day 5, but did refer for frenulum clipping on day 4. (I am
happy to report that he gained 10.3 ounces in 72 hours by the only
consistent nude weights on my BabyWeigh scale!)

 

While this case was a bit extreme, the basic scenario is all too common. How
do we get the word out??

 

Flossie Rollhauser, IBCLC, RLC

Maryland (where we may actually finally be getting winter weather!)


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