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Lactation Information and Discussion <[log in to unmask]>
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Thu, 2 Oct 2003 20:49:46 EDT
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Diane says,

When we find that a "correct" component of latch doesn't make much
difference in nipple pain... maybe it's because it's not as correct as we
think it is.  I've had my own paradigm for a good latch turned on its ear
several times in several ways in the past year.  It's humbling, confusing...
and very exciting.

I have a feeling that what is "right" for one mom/baby may not be "right" for
another mom/baby.  And I suspect there is a whole lot more to nipple pain
than just an incorrect latch.  I think that a baby can have a marvelous latch
(whatever that is), but if mom has short stubby nipples and non-stretchy breast
tissue, I suspect there is going to be some compression of the nipple because
it simply CAN'T get back far enough in the baby's mouth and WILL be compressed
between the tongue and the hard palate.  I suspect that mothers whose areolar
color did not change significantly -- particularly those that have unusually
light color areola with minimal change -- will probably have more trouble with
sore nipples -- all other things being equal.  It sorta goes back to the "fair
skin" notion, but it isn't the fairness of the skin, but the lack of change
in color in the areola.  I suspect there are many more women that have nipple
pain that may be related to lack of color change, but may be more related to
the fact that they have nipple discomfort a lot of the time -- they are the ones
that get "noodgy" with breast play during love making; who have very tender
nipples/breasts during pregnancy and during their periods.  These women end up
experiencing a lot of nipple pain....if they can tough it out, it gets better.


While I think latch is important -- very important -- I think we have to step
back and look at what is going on and ask more questions of the mom when we
hear about her painful nipples and not just make an assumption that the latch
is wrong.

I've used the Matterhorn idea that Diane has promoted for latch, and also the
Big Mac sandwich.  I do use dominant hand position to support the baby in the
early days to help "roll" the baby onto the breast because I don't see the
mom/baby able to get a big enough mouthful in the cradle hold, though the vast
majority of my moms are able to make the switch from football/cross cradle to
cradle within a couple of weeks.  Sometimes they have to go back to dominant
hand (like the mom today -- she's been using cradle, baby is three weeks old,
and he's getting sloppy at latching and isn't taking enough in his mouth.  When
we went back to dominant hand, the mother said it was much better).

I'm sensitive to Karen's comment about moms feeling as though they are
"stuck" in whatever position they learned in the hospital, and aren't able to  make
that transfer to the kind of position they see in all the books.  So I hope we
can get by that problem.

It'll be interesting to see what comes up over time about latch.  I hope we
are all able to give up our own pet ways of doing things if something better
comes along -- and that we are open to new ideas and new ways of trying things
-- and that we realize there probably isn't just one way that is going to work
for all mothers.  It IS exciting, just as Diane said....even if some of us
have to be pulled along, kicking & screaming all the way.  I guess if we are
moving, that's what is important!  :>)


Jan Barger, RN, MA, IBCLC, RLC
Wheaton, Illinois
www.lactationeducationconsultants.com

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