Re Helen's mother with the 4 week old baby who has very painful, damaged
nipples and has a previous history of this with other babies.

Another thing to consider here helen could be the baby's oral anatomy. I
think you did eliminate (lovely word!) tongue tie as cause, but perhaps it
may be a high palate or another tongue anomaly.

I've found palate shapes tend to run in families so when you mentioned
she'd had the same problems previously it waved red flags for me.  Babies
with a high arch to their palate tend to flick the nipple up into the
'cavity' very easily, and have rarely experienced the nipple tip at the
junction of the soft and hard palate, therefore resisting it occuring.
The solution:  ahh, if I only had it I'd be a wealthy woman!
Good latch is crucial here - and by good latch I mean brilliant latch.
There really needs to be so much breast tissue in the baby's mouth that the
nipple is forced further back, past the high palate to the correct junction
spot.  Try all kinds of techniques to achieve this - be a lateral thinker.
Sometimes I get my best results by sitting the babe beside the mother so
that the chin is on the underside of the breast - gravity seems to help get
more breast tissue in like this; someitmes the mother leaning over the baby
works -again with gravity on her side.
Now you won't hear me say this very often - but a nipple shield may be
useful here.  The baby isn't able to flick the formed shape into the arch
so easily.

If that is the problem really the only solution is a tincture of time. As
the baby's mouth grows he starts to take more breast tissue in anyway - and
I wonder if that palate assumes a better shape.  I have assisted many
mothers who run the gamut of trying everything, then around 8 to 10 weeks
(often just after having the baby off the breast for quite some time to
allow healing) they come to see me - I help put the baby on the breast and
the feed is pain free for the first time ever. They think I'm a miracle
worker - but I'm not, I was just in the right spot at the right
developmental time.  They go on to breastfeed happily - and it's often for
an extended time too - reluctant to wean I think after the difficulty
getting it started in the first place.

Now funny suck/tongue anomaly that's a suck training issue. I think I've
probably raved on long enough so will leave that unless you feel that is
specifically the problem.

Good luck
Denise

****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
****************************************************

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