Ann:
  How frustrating for this dedicated mother!!  Might an oral trauma @ birth (bulb syringe?) explain this situation?   And then there's the "flat nipple" syndrome....a little bit of nipple stimulation prior to latch could help this baby feel that there is something firm to latch onto....just my thoughts...
  Joy
  LLL Wyoming
   
  ANNMarie <[log in to unmask]> wrote:
  Hello all,



I have asked mom’s permission to post.



I am perplexed how to help this dyad I am working with. Baby is about 3
weeks old; from birth baby has fussed at latch on. Mom had flat nipples
according to RNs (there are no LCs there) at hospital but they look like
they stick out fairly well now. Baby fusses while trying to latch, many
times up to 30 minutes worth before mom can get him on the breast. (Since
this has been the same since birth I don’t think it is related to a strong
letdown.)



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).



Baby can stick tongue out fine, mom is not sore at all, baby is gaining
well. There would seem like there is no problem but mom feels like she is
torturing her baby and says she is losing “her happy baby”. 



I do not question this moms desire to breastfeed and she lives in house with
her mother who nursed multiple children into toddler hood. (She is a young
mom, but college age) Her mother validates how much this baby is usually
crying at latch on.



I was assured bottles were not brought into the picture until this last week
when mom decided she might bottle-feed EBM so she wouldn’t torture her baby
anymore. She would much prefer to have baby be at the breast. Baby takes
bottle with no problems.



She said a nipple shield was tried in the hospital but he didn’t like it so
she threw it away. She is open to trying it again as I think he may be open
to in now that her milk is well established and there to encourage his
sucking. I have some on order (I have not set up a practice as an IBCLC yet
as I just passed the exam but instead work in a WIC project and just got
approval to get a few nipple shields to have on hand. This mom can not
afford to visit the one local IBCLC who is only in town on alternating
weeks.).



Do any of you have any other ideas that may help? Trying a shield or the
bottle-feeding of EBM is kind of what we have been left with. I really feel
if the baby takes the shield it will bridge him to us eventually weaning him
off once they get over whatever hump is in their way.



Added, baby has seen doctor and chiropractor and check out fine.



Thank you for any advice, hope I listed all the information clearly enough. 







..· ´¨¨)) -:¦:-
¸.·´ .·´¨¨))
((¸¸.·´ ..·´ -:¦:- 
-:¦:- ((¸¸.·´* ~Ann Marie Mackin, BA, IBCLC, CLC, LLLL, BF Peer Counselor (I
just keep collecting those letters it seems, lol)




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