Dianne, I would first explain skin to skin contact to the mom, and suggest
rallying the forces, and getting help for the 3 year old so that she can sta
out of the car and get into bed and take care of her baby and herself.

The cracks are due to poor positioning, and may get worse with ascending
staph A, etc, if not cared for.  Normal saline soaks are helpful, as is
gentle washing with soap and water. (not antibacterial soap). Proper
positioning with chin IN and nose tipped a bit back (off center latch, as
described by Newman at www.drjacknewman.com) in the videos there is key. Use
of APNO ointment is also key to avoid worsening infection.  Fixing the latch
is FIRST, and cue feeding is also key....as scheduling a baby who is not
gaining is pointless and even detrimental.  I am sure this is not
everything, but it's a start.


Kathleen Bruce RN IBCLC
Independent consultant:
Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
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Kathleen

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