I want to share an experience I had in the pediatric office where I work.
I'd love to hear if others have seen this.

Mother of a two day old with mild, visible jaundice to mid trunk came in
with her baby for her first appointment. (9mg/dl) The baby had lost 10% of
her body weight and mom's nipples were abraded, the left side cracked.  The
baby's frenulum was far back and very thin, her palate seemed normal, not
too highly arched or narrow.

Baby was very eager to latch, popping on shallowly as soon as she came in
proximity to the nipple and then clicking and munching.  We tried oral
exercises, football hold, cross cradle, letting baby find the nipple on her
own starting from an upright position between the breasts, even a nipple
shield all to no avail. I felt so concerned that we were going nowhere and
even damaging mom's nipples further. The nipples were misshapen "lipstick"
when she detached.

All of this took 1.5 hours and was only possible because I had no other
patients for the day (rare).

Then I remembered reading that some babies like a more upright position and
suggested mom have baby's body angled down onto her lap.  Mom actually had
the baby straddle her leg and voila! The latch became pain free, obviously
deeper since her face was now pressed into the breast.  But here's the
kicker: as the baby nursed over the next ten or so minutes dad and I watched
the jaundice decrease until the baby's color matched her mother's skin tone.
We both commented on it. Baby also had a big meconium BM.  When the doctor
came in she saw no need for a repeated heel stick.

Mom will nurse and supplement with pumped milk by cup until she returns for
a wt. check on Tuesday.

Valerie Vanderlip, IBCLC
Marietta, GA USA

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