The baby could be using the tongue abnormally, compressing the nipple
base with the elevated tongue (see Geddes frenulotomy article in
Pediatrics last year). We've seen the same thing in our study, which we
just wrapped up. The nipple looks fine when it comes out of the mouth,
and the latch looks good from the outside too.
This is usually the result of a tongue-tie. It might even be a minimal
one, which you ordinarily wouldn't think anything of. Once the nipple
skin is injured, it can become infected. Washing with mild soap and
water several times a day decreases the chance of nipple infection and
mastitis.
Catherine Watson Genna, BS, IBCLC NYC
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