**Baby:  Gaining weight normally, happy, no more crying.  No  tight 
frenulum (under tongue or to either lip).  Palate feels normal, no  high arch or 
bubble.  Lots of audible swallowing throughout feeding.   And no distress 
noted during times of milk ejection reflexes.  The only  thing that I saw that 
might be problematic is how “wiggly" baby is at the  breast**
 
When I see a baby who is seemingly uncomfortable while breastfeeding, legs  
moving or being drawn up, I think about digestive issues, from something as 
 simple as needing to burp, to allergy/sensitivity to something mom is 
eating  which has caused irritation along the GI tract, to baby's difficulty  
swallowing due to abnormal tongue movement as in posterior tongue-tie (reflux  
included with tongue-tie and/or food sensitivity). 
 
I recently observed one 3.5 mos old who needed a second tongue-tie  
revision due to inadequate first time clipping who went from constant  motion at 
the breast to calm, longer feeds.  This brought up a discussion  in my group 
where two other babies were unsettled at breast; one could be mom's  diet 
which she's investigating with a nutritionist, and the other likely due to  
lowered supply which is being worked on.
All moms were unaware of normal infant calm when at breast and the one with 
 the frenulum issue expressed relief and joy that now breastfeeding was  
pleasurable for both baby and herself and that she found baby now 
breastfeeding  to sleep and for comfort.  The other two are eager to reach that same  
experience.
 
Based on my observation of babies of any age, newborn included, the baby  
who pummels the breast, pulls back, is off and on frequently with frantic 
hand  movement is experiencing difficulty handling normal flow and swallowing 
which  most often is due to tongue restriction.  (The older baby who grasps 
mom's  breast or plays with her bra strap is just doing normal hand 
exploration, the  rest of his body remains relaxed). This is a simplified 
explanation, but the  main point is that, as you saw and have questioned, a baby who is 
wiggly at  breast, whether it occurs from top or bottom, is uncomfortable 
and teasing  out why is important. I wonder why this mom continues to have 
nipple damage if  breastfeeding/ infant suck is not problematic?  Some  of our 
cases  involve lengthy investigation and a ruling out of possible issues, 
and I suggest  you keep exploring and follow your instincts that something 
still isn't quite  right.  Please let us know the outcome.
 
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
 

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