what possible reasons for scabs in the center of the nipple?

[emnic77]

I am trying to help a friend out. She has been nursing for two weeks (since her baby was born) and has been nursing in pain. I have not been able to help her face to face yet, due to a cold, but only over the phone. She is very discouraged and has not had any luck with lactation consultants from the hospital she delivered at, She is attending a LLLI meeting tomorrow, but I wanted to ask here for her as well.

-scabs in the middle of her nipple. not healing.

-fussy latch on, especially on one side, head bobbing, pulling off (I gave her some tips about dealing with a baby that hates forceful let down)

-she feels like the baby's tongue is not covering his bottom gums, and that's she being "chomped on."

The lactation consultants she's seen have all said that his latch is fine, but I don't see how that's possible.

The last one flagged tongue tie to me, but her dr said no tongue tie. I suggested a second opinion, and she did not feel that her dr really took it seriously, either, and more or less brushed her off. The scab in the MIDDLE of the nipple suggests something interfering with the roof of his mouth, iirc? I'm not sure what positioning I can suggest to her to help with that, if I'm right about the roof of the mouth problem.

I know nipple shields can be a dirty word, but would it be worth it to her to try them for a couple days?

Anything else I can suggest to her? I also suggested she be checked for thrush. I do hope she gets some help at the meeting tomorrow, I feel so awful for her, she is such a trooper for nursing in such severe pain - but I can tell that it's really getting to her.

[Marissamom]

I had similar with my DD. I never ended up finding a true solution, but now I think she may have a posterior tongue-tie. 

[homemademom]

Do the scabs form a line, like a ridge right across her nipple? My ds had a posterior tongue tie and this is what my nipple looked like. From what I understand, it's because the nipple is not being pulled in far enough, so it's getting crushed between the hard and soft palate, hence the line/ridge. My LC, mw, ped, and CST all said nothing was wrong with my ds either. They thought his suck and latch were perfect, too.  But nope. I think posterior tongue ties are diagnosed by what's going on with the mom and baby, not so much by how it all "looks" (including the frenulum under the baby's tongue; my ds's was so minor, we never imagined that it was causing a restriction). I diagnosed it myself based on the signs of PTT and then had it confirmed (and treated) by a pediatric dentist who specializes in tongue tie laser surgery. Maybe forward these to your friend?  

http://www.cwgenna.com/quickhelp.html

http://www.llli.org/llleaderweb/lv/lvaprmay02p27.html 

http://www.lunalactation.com/KnoxTT.pdf  

http://www.lowmilksupply.org/tonguetie.shtml

[emnic77]

Thank you for these links. I did find an online resource that happens to be local to us with a consultant that specializes in ties, especially posterior. I really do think the baby has a posterior tongue-tie, every sign is pointing to that. I wish I could've met up with her this week to see her latch, but from what she's describing (flanged lips, chin positioning) his latch might be okay.

I will forward those links to her, thank you so much.

[homemademom]

Originally Posted by emnic77 

Thank you for these links. I did find an online resource that happens to be local to us with a consultant that specializes in ties, especially posterior. I really do think the baby has a posterior tongue-tie, every sign is pointing to that. I wish I could've met up with her this week to see her latch, but from what she's describing (flanged lips, chin positioning) his latch might be okay.

I will forward those links to her, thank you so much.

I'm glad you have someone local!  That's really fortunate. I definitely think you can have a proper looking latch and still have it be tongue tie. The chomping would be a big sign to me.

[emnic77]

Originally Posted by homemademom 

I'm glad you have someone local!  That's really fortunate. I definitely think you can have a proper looking latch and still have it be tongue tie. The chomping would be a big sign to me.

Yes, and she said she can SEE that his tongue is not covering his bottom gums. She's smart enough to know it's not supposed to be like that, and it really bothers me that her lactation consultants and doctor have brushed her off with an "it's fine."  :(  She is also going to ask her midwife about it tomorrow when she sees her. I hope someone can help get this diagnosed and fixed if it truly is the problem.

[gemasita]

My LC said a scab in the middle of the nipple means "tongue."  Could be several things but all have to do with the tongue.  I had this too but got him checked for posterior tongue tie by someone who specializes in it and that wasn't it.  :-(