Thanks for your response Catherine!
you write;
>>Usually the mom is unable to latch as well alone as when we are with
them, so if you were noticing the baby chewing on the nipple, I'm sure
he was doing a job on mom after you left<<

You are oh, so right!  My frustration lies with the fact that despite 2
consults and my confidence that Mom knows as much about facilitating the
proper latch as I can teach her, we can't seem to avoid this nipple trauma.
you ask;
>>Did you try an extreme asymmetrical latch?  Is baby tongue tied or does
he have a short jaw?  In either case, baby would be more likely to chew
than suck.<

I always use an assymetrical latch, but extreme.....I don't know...assuming I
know what you mean, I'll try it when I go back. The baby isn't tongue tied
(too Bad!) and jaw isn't recessed if thats what you mean by short.
you also suggest;
>>Sometimes
sidelying works best, baby is placed with his lips below the mom's
nipple, so he has to stretch up to it.  When he opens wide, mom pulls
him in from between his shoulder blades, so his head extends more. <<
I considered this but Mom is fairly heavy, with bulging post c/s belly thus I
was worried about the baby's body being too far away from head .....but maybe
upside down might work?
I'm also still wondering about the significance of the nipple characteristics
as I described ie. assymetrical with irregular border. Have you ever noticed
that sometimes the tissue of a previously inverted nipple once everted,
appears much more *tissue like* than the *skin like* appearance of a normal
nipple AND that these (former) nipples seem much more friable? HER nipple
appearance (although certainly not at all inverted!) is somewhere in
between.....does this make sense?

Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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