nipple pain, maybe tongue-tie

[Guest guest]

Hi all!

I’d like to have your wise opinion about one of

my client. Sorry in advance for my poor English!

Little girl born on Oct 17th, vaginal

birth with epidural. Wight 2,900 gr. On 19th weight 2,680.

1st day no interest in sucking. 2° day mom

tells “she started to root”, the midwives teach her to nurse only

laying at bed. When at home she started to try to nurse on a chair, and to feel

pain (she wasn’t sure to have really no pain at H, probably she still had)

 and saw little cracks on nipples.

Due to the weight loss, they started to give some

bottles of formula, then throw away bottles and gave formula only with spoon.

I saw her on Oct 25th.

Left nipple was the worsest, with a semicircle crack at

the line below between nipple and areola, and a pinched vertical line .

Right nipple better, but a little crack at the nipple

center.

She says feels like a “burn” and stings up

to armpit. Pain is more at latch on, expecially under the nipple. She feels

better with cold packs.

Positioning and latch on were totally wrong, and the left

areola was really pink and shiny due to the much ointment she put on.

Baby has in my opinion a tongue tie, but doesn’t

open wide so I was not sure it is the 1st problem, surely the

positioning is very wrong.

I told her to stop ointments and show her how to make

a good positioning, with cross cradle hold.

The baby sleep too much , nursing just 5 times /day.

Sleeply, of course.  3-4 poohs. Some concentrate pees. Thus, I told her about

the need to make her eat more, keep her awake, more times and so on.

2 days after the visit she calls and tells me things

are going better but she thinks she has less milk, as the baby nurse at breast

less time. They give formula with spoon, tired to do that .

I speak again about SNS and pump (1st time

I saw her I spoke a bit about those but she was very reluctant). On afternoon

she calls really upset and says she cannot offer again the breast ‘cause

too much pain, I tell her to come immediately and I will try to help her.

They come, the baby is really sleepy, and we need a

whole hour to wake her up and put on breast but the mom has a lot of trouble in

handling her correctly and is terrified when the baby open the mouth, so she is

not able to be fast on latching on. We try with rugby too. She is really upset.

Anyway, the crack on right nipple is not more visible

and she confirms that now she has trouble just on left side.

I saw the tongue again and now I am pretty sure it is

tied. If you want I have a photo, even if it is not good quality (made with a

mobile and baby was moving)

My question is: there is something more I can do for

this mom? Can a tongue tie cracks just one nipple and not the other one?

Many  thanks for yr suggestions!

a Carabetta, PP_IBCLC

Rome,

Italy

www.latteecoccole.it

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