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03 What causes nipple pain? Improper latch-- need lactation support to help with proper latch on, good seal 04 True/false: baby should be pulled into breast. False! Do not pull baby into breast, let baby tilt head back for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the movement of the cranio-cervical spine-- causes nipple trauma. Make sure crook of arm in cradle position does not block baby from being able to fully tilt back. 05 Should a latch be symmetric or asymmetric? Asymmetric! A baby should form a teat with breast tissue underneath the nipple as part of a latch 06 What is a symmetric latch Not a good latch, causes nipple damage 07 Asymmetric latch Optimal attachment to the breast, where the baby's lips are not centered in relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue underneath the nipple as part of a latch 08 Do nipple creams work? Continued questions of effectiveness, fear of ingestion by baby 09 Should a frenotomy be suggested for tongue tie? No study was able to report that frenotomy led to better long term breastfeeding 10 Tongue tied breastfeeder -complete feeding assessment and suggest ways to optimize latch. -refer onward for diagnosis (have PCP diagnose TT) -provide support


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