Tali wirtes:

<Painful latch that looks good from the outside
but causes much pain and nipple compression leading to compression sores.
Baby has low palate and good to strong suck.>

How a latch looks from the outside is missing at least half of the latch equation. I have labeled it a "Cinderella Latch" when the mother's nippleareolar complex responds easily to the infant's oral activity so that mother and baby are "happy everafter".

Of course, other factors can exist. If you do a digital exam, does the baby seem to bite? How does your finger feel after the baby has been scking on int for a few minutes?? I do recognize that craniosacral treatment may be i order for babies with rapid or medically assisted births at times, to be sure the cranial bones are not interfering with any of the cranial nerves controlling the suckling muscles.

However, the word "compression marks" caught my eye.  If this mother had 2000+ cc. of IV fluids in any one 24 hour period, especially if she received IV's with pitocin, and especially if her breast is pendulous, the nipple areolar complex is often the site of edema, especiallyif a pump has encouraged Interstitial fluid to move forward to neutralize the vacuum.

A good plan for any mom is to have her assume an antigravity position if pendulous or very full, and soften the areola just before each latching for the first week or more. Fingertip expression can work wonders for some moms, but for many, it takes Reverse Pressure Softening to free up the areola to extend the nipple deeply into the baby's mouth to protect the nipple and allow the tongue to ripple appropriately over the areola and the milk ducts just underneath.

LLLI | Too Swollen to Latch On? - La Leche League International www.llli.org/llleaderweb/lv/lvaprmay03p38.html

K. Jean Cotterman RNC-E, IBCLC
WIC  Volunteer LC  Dayton OH

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