Kathy Bruce,

If this were my client, I would have advised getting this baby off the breast
and mom pumping very early. Sounds like the baby had a terrible suck. In
situation like this, when direct effective breastfeeding isn't happening, go
for indirect feeding of mom's milk until the problems in both are fixed. Get
mom pumping and feed the baby with another device while each is treated
separately - mom for the nipple stuff, and baby for the poor sucking
response. Keeping an ineffectively-feeding baby at the breast is
counterproductive. You know the old adage - if it's not working, try
something else.

Linda Smith, private practice in Dayton OH