Lisa, I have a couple thoughts. First, culture the nipples, it could be
bacterial infection, even MRSA. Second, you say mom has low supply which has
never "caught up." Is this still an issue and perhaps baby is sucking very
hard??? Sounds silly to say it, but I've seen where a lowish supply in early
days lead to sore nipples, resolved when milk kicked in. Are things better
with a supply line (supplementer)? Does the baby have other signs or
symptoms to suggest anatomical problems or swallowing issues (you mention
strange breathing sounds and a poor seal, leaking, on breast and bottle)?
Perhaps a submucousal cleft (my mind is blank on the correct term here)?
Therefore perhaps further exploration of those issues with a speech
pathologist or peds OT or peds ENT etc.
Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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