Hello All!
My name is Traci and I have been an LC for 5 years. I
have just recently started a private practice in
Wichita Falls, Tx.
I have a client that has serious ulcers on both
nipples, and has given permission for me to post to
the group. Her nipples look like mirror images of each
other. The ulcer on the right side is at the 11:00
position, and the one on the left side is at the 1:00
position. Baby is 4 weeks old, and a little barracuda.
His bottom lip flanges, but I cannot see the tongue,
and his top lip tends to roll under and mom will pull
it out.
The left nipple is healing slowly. The ulcerated area
is bright red and the new tissue looks very healthy.
The right side is a yellowish color. This one
developed just in the last few days.
She also has deep fissures across each niple.
I observed several attempts at nursing. Mom has good
positioning, baby has very audible swallow, and is
very alert. White compression stripe is apparent when
baby lets go of nipple.
As I looked at mom's nipples, something just didn't
seem right to me. Her areolas seem way to round, like
the end of a watermelon. She has a tiny stump of a
nipple, and stated she's never had "perky" nipples
like you'd see on models. So, I am suspecting flat
nipples, and baby has pulled them out a little from
nursing. Mom said no one ever looked at her nipples at
any time.
Baby is gaining weight, (7.1 at birth, now 9 lbs). Mom
leaks lots of milk, but she is in so much pain she's
ready to give up. So far she's still 110% committed to
breastfeeding.
She's using Lansinoh, and has just purchased a nipple
shell she began using yesterday. I showed her
different positions, but all are painful. I suggested
she pump after feedings and cup feed baby when he
first wakes to stave off hunger so she can take some
time getting him positioned. He seems to sleep through
early hunger cues. I am open to any suggestions to
tell mom how to nurse comfortably. Of course, pain and
injured nipples are first concern.
Thank you so much for any sugestions.
Traci Roberts Mills
MotherNurture Lactation Services
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