Hello Lactnetters,
I have an unusual circumstance with a baby who came into my office
yesterday. Would like to have your collective wisdom on this one. This
little guy is 3 1/2 weeks old and is 7#3.6 oz. Birth weight was 7#0 oz. He
looks fairly scrawney and is discontent in a short time after feeding . Test
weigh showed 2 oz intake total on both breasts, probably in about an hour of
time.  Mom has had sore nipples from the start. He has calloused lips, not
blisters, callouses which are thick and white on the entire top and bottom
lip going from corner to corner.  The bottow lip is not as thick looking,
but still white. At the breast his chin excursions are extremely long and
rapid and you can see the lips going up and down against the breast. Sucking
on my finger, the suck feels relatively normal. I tried mom with a nipple
shield which seemed a little more comofrtable for her and I held his chin
down to get a wider latch. This helped, but it took a lot of effort to get
the chin down and my finger kept being pushed away, even when it was gauze
covered. I think supply is low now. I do not know how to correct this suck
problem. As a tempporary measure I advised limiting feeds to 15 minutes each
breast, with nipple shield and holding chin down firmly. Also, pump 10
minutes after feeds and supplement 1 to 1 1/2 oz after feeds, either EBM or
ABM if necessary. Mom didn't want to try SNS due to nipple soreness so
she'll use a bottle for supplementing. Mom had previously been prescribed
Newman's ointment but was using in incorrectly, corrected that and also had
ped prescribe nystatin for baby. Her nipples looked white and pretty mushy
after feeds. 
I am most concerned about the suck. Any ideas?
Judy Gutowski, BA, IBCLC
Breastfeeding Matters
Western PA - cold, cloudy and with a light snow on the ground
 

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