Yesterday I was reminded yet again of how different positions can help.

The mother has inverted nipples that evert readily but are quite large.  She
hadn't realized there was a problem until the 4 week check, by which time
her daughter had dropped well below birthweight.  With our best (brief)
efforts, the baby transferred 3 ml milk from both breasts.

11 days later, with appropriate feeding and a hefty weight gain, she is
still unable to trigger a let-down... when they're sitting up.

But lying down together, with the baby "skootched" a bit more than usual
toward mom's feet, extends the baby's head just a smidgen more, and lands
her lower jaw just a bit farther on the breast.  The mother was delighted to
see a 27 ml intake from one side alone.

Obviously there's still some growing needed, but they're now able to do some
truly nutritive nursing, so long as they're lying down.

In retrospect, the mom thinks that must be why her daughter nursed "all
night" during that first month.  It was probably the night nursings - lying
down - that kept her fed at all.

--
Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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