Hi, I have a new client 2weeks postpartum (permission to post) who had her breast implants done through her belly button 7 years ago, she went from a round A cup to a D cup (she is very small framed). She told me that the implants were placed in front of the muscle. Upon exam, her breasts are very ROUND with a spacing between breasts. The tissue is very taut, with visable veining. She feels that she is no longer engorged, just full. Her nipples are everted, yet the shank is not extreemly long (1/4" to 1/3"). 7lb. Male baby with normal oral structure with no tongue tie or labial frenulum, tongue lifts well,(digital exam done after first side was complete), shows baby bunching his tongue only with the first few sucks, then cups appropriatly and sucks strongly. Upon return to the Pedi office at 1.5 wk, he's regained his birth weight plus 12 oz. To make a long story shorter, her baby latched on well and was bf on discharge from hospital. At her initial visit (at 5 days) with Pedi, baby was jaundice, and had lost weight :( SO the obvious treatment was to ABM Or EBM feed with a bottle until both problems were resolved. She did so with a Avent bottle/nipple. Thankfully she had the knowledge to pump at least every 4 hours and give EBM, and is now able to pump between 6 and 8 oz each time, while the baby only takes in about 3 oz each 3 hour feeding. NOw she can't get baby back to breast. Initally we attempted to latch baby onto her breast in 2 or 3 positions, baby appears unable to get wide enough mouth to latch deeply, causing mom to complain of pain with inital latch - now I'm thinking that because the breast tissue was so tight he couldn't latch on - she was unable to sandwich nipple/breast. He roots appropriatly. Mom very eager to get him to breast she wanted to try a nipple shield, so after applying, were able to get baby latched on, of course not as deep as I would like, but deep enough for baby to transfer milk, and was satisfied after feeding. We discussed attempting direct bf, and before frustration set in use the shield, frequent feedings as the baby adjusted to bf with shield, insurance pumping, stopping the use of pacifiers (which was limited already). She called me the next day and said that her nipples were already becoming sore and itchy (no visable sign of thrush on initial visit), baby feeding frequently. Encouraged her to continue to try deep latch, and if unable to do so without pain revert back to using bottle in a "paced" method with a shorter teat. I am seeing her again on Monday, I didn't think of telling her to attempt to pump her nipple out, and soften her breast before attempting latch on, which I will do. She finds side lying their best position. My questions to you... Have you ever had a women have her augmentation via the belly button? Would that pose any problems? (she has adaquate milk output at this time and full nipple sensation). Does augmentation cause increased nipple sensation? What methods have you used to promote a deeper latch on a tight breast? Any other ideas/tips would be greatly appreciated. Brenda Dalton RNC IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html