I've enjoyed reading Lactnet the last couple months, now I need some advice
for a mom I'm working with.  I saw this mom on Day 3 and she was having
attachment problems, said she had only had one successful nursing and that
was in the hospital with the nurse helping and they really compressed the
breast behind the areola.  This mom has large, but not huge nipples.  Baby
can attach properly, but her upper lip occludes her nostrils and she pulls
off.  We tried all 3 standard positions with all kinds of adjustments without
success.  I finally tried the shield and there was no occlusion, but this
little peanut wasn't strong enough to pull much milk through.  Her weight had
dropped to close to 10% so I sent them home pumping and bottle-feeding.  I
asked another LC about this and she has never seen it, so had no suggestions.
 At this point the only thing I can think of is to wait until baby is bigger
and hopefully outgrows the problem.  Any suggestions?

    I also have a question about whether anybody feels fenugreek tincture is
more effective than capsules.  I seem to have a large number of moms without
risk factors (or at least any I've been able to identify) who don't have
enough milk.  I also suggest fenugreek, but while they generally feel their
supply increases "some" it hasn't helped anyone get a full milk supply.  Any
suggestions are appreciated.

Andrea Tran, RN, ICCE, CLE
Lactation Specialist in Beautiful Boulder Colorado

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