I need help as I am at a brick wall. I have been working with a mom who came to me 10 days postpartum,about the begining of Feb. with stage 3 nipple trauma, very low milk supply, and baby not gaining weight. We have gotten baby's weight up with at first finger feeding and bottles as he was so slow finger feeding, mom's milk supply is back and can pump 3 to 4 ounces a time, nipples are finally healed took a very long time. She is still reporting pain with pumping. The only way mom can nurse is with a shield, otherwise it is too painful.  I thought at first it was due to the severe nipple trauma.With the shield, baby sucks 3 to 4 times before a swallow. On the breast the baby sucks 1 to 2 times and swallows. He has been to the kinesiologist and jaw was adjusted, mom noticed that the baby could open his mouth wider after the visit, but he still pinches her breast. There is no frenulum to cut and no one here knows anything about posterior tongue tie. No matter what latch is used after about 3 to 4 sucks it hurts mom. I feel that we are stuck in that when SNS is stopped and mom uses the nipple shield baby loses weight, if nipple shield is not used nipples are tramatized. We have tried pulling down on chin ( something I do not like to do) when baby nurses but still a slight pain. My question is that we are fairly sure that Mom has Raynauds and we have just started to treat ( nipples hurt after pumping, nipples blanched after pumping, nipples sore after feeding with shield, going into the cold hurts her nipples even when she is dressed  and she needs to wear a vest to keep her nipples warm.), would this contibute to a lack of  elasticity of her nipples and the baby not able to keep the nipple pulled to the back of his mouth. I have not had such a difficult case for years!! Tonight dad yelled at me as he wants Mom to stop and she does not want to, and it is my fault because I am encouraging her--- that is a first for me after 20 years of consulting.
Thank God for this forum.
Camille

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