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Lactation Information and Discussion <[log in to unmask]>
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Thu, 13 Dec 2007 14:15:29 -0500
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 I have been thinking about the mom with severe nipple pain. Royce wrote:

I recently saw a client that has a 3+ week old male and a 26 month old
female.  (snip)

Mom had decreased nursing to one time per 24 hours due to pain!  She began
giving ABM via bottle @ day 5; amazingly baby went to breast and nursed
eagerly transferring 32 ml from one breast.  His latch was beautiful and
there was NO evidence of TT. We visited while babe was nursing and mom never
c/o'd of pain, winced or gave any other sign of distress.  Nipples were
without evidence of trauma altho' she said that was b/c she had only been
nursing one time/day. She had tried APNO but stated she was afraid to use it
due to steroid, she also stated that Soothies (hydrogel patches) did not
work.  Every thing I offered was something tried and failed.  I strongly
encouraged mom to change positions to decrease irritation, express MM and
allow to air dry after nursing, use APNO and then try hydrogel patches.  She
had decided against Soothies b/c they were "disposable & single use."  I
assured her they could be reused (place on plastic card and in zip lock bag
when not in use) as long as they were not dry.

I f/u'd per phone the day after the visit; she had NOT followed my
suggestions but stated that I "encouraged" her and that she would again try.
Do you all have any suggestions? I am experienced but at a loss with this
mom.
I do agree with those who have written that many moms seek help while feeling ambivalent about whether they really want to breastfeed, but I had some other thoughts about this situation. Royce, I know that not everything comes across perfectly in email, but as I am reading your posts, I see that a good part of your recommendations to mom include strategies she told you she was uncomfortable with. Mom was not comfortable with APNO due to the steroids--I would not be either. I do sometimes suggest APNO to my clients, b/c most moms do not have the concern about meds that I personally do, but I do suggest that moms avoid using the steroids for any length of time. I also know that hydrogels are commonly used, but again I would not personally use them--there is no proof that the source acrylimide is made safe when manufactured in this way. I realize that was not the mom's complaint, but she did say that they had not worked for her. 

Do you think it might be possible that the issue of mom not following your suggestions is a bit if a distraction from looking into other possible causes of her pain? I once worked with a mom where I could find no cause of her pain whatsoever and she even went into therapy to address the possibility of the pain being sourced in some early trauma experiences. It wasn't until I saw her with her next baby, that we finally figured out that all of her children had posterior tongue-ties. Also, if this might be helpful, my topical treatment of choice for nipple pain is colloidal silver. Also, when I cannot find a source of pain, I look carefully at the baby's structure and often refer for CST. While the birth may have been "uneventful" for mom, it might have been quite different for the baby. 

Jennifer Tow, IBCLC, CT, USA

Intuitive Parenting Network LLC



 





 



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