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Lactation Information and Discussion <[log in to unmask]>
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Wed, 16 Jan 2008 10:39:57 EST
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I would bet that this mom is still having trouble, and not realizing it,  
with obtaining a deep enough latch for baby.  I've often found that I can  assist 
mom and baby to obtain a deep latch, but then need to have mom help baby  
latch without my assistance, a couple of times before the visit is over, so that  
mom really knows how to do it.  I see moms who continue having difficulty  
because they put their breast in baby's mouth rather than bring baby to breast  
with head somewhat extended so chin first occurs with latch.  Then poor  baby 
is left trying to mouth the breast without that stimulation further back on  
his palate and wags his head back and forth in frustration.  I tell moms  it's 
like trying to get a big fully inflated balloon in ones mouth and that's  next 
to impossible.  Breast shaping, as in breast sandwich technique, can  help 
baby to get a mouthful more readily.  And, of course, it always seems  that 
babies who have trouble latching who need deep stimulation, have moms with  large, 
soft breasts and flattish nipples or moms whose breasts are very taut and  
this lack of elasticity makes bringing the breast in more difficult.
 
So, I'd suggest you see mom again and try to have her practice while with  
you, even if it takes a couple of feeds for mom and baby to get it.   Depending 
on baby's and moms frustration levels, a shield could be a useful  temporary 
tool if latching without doesn't happen consistently.  Often baby  needs a few 
consecutive breastfeeds before he realizes and is assured that  breastfeeding 
will give him what he needs.  This mom could also try  bringing baby to breast 
before he's fully awake, walking or just standing up so  her breast falls 
naturally and baby is underneath; I've had these methods work  when the cycle of 
stress of latching needs to be broken.  Making sure   there is no tongue 
restriction or other anatomical difficulties is important,  too.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
When I did a home visit and observed what baby was doing it appears he is  
getting frustrated by trying to form the nipple enough to get it to hit that  
sweet spot to stimulate his sucking reflex.  Perhaps the nipples 
are  too soft or short for him?  I helped mom reposition the baby and he 
fussed  hardly at all at latch for that feeding, but in follow up calls she said 
it was  still just as difficult for them at most feedings even with new
positioning  (tried to use nose to nipple and get real deep latch, she was 
nursing in  football hold and we tried  cross-cradle).







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