Based on my research, common observations relating to nipple trauma were:
Restricted movement of the baby's head, neck and shoulders
Restriction of the baby's instinctive skill to seek the breast and locate the nipple
The heel of the hand pressing over the shoulder (7th cervical vertebrae) appearing to activate the 'Moro Reflex' resulting in the baby hyper-extending the head
Nipple to Nose, appearing to result in the nipple entering the anterior hard palate
Face-To-Breast 'asymmetry' (one or more of the 4 points - nose, chin and both cheeks - not symmetrical and in contact with the breast) preventing the baby from effectively using intra-oral vacuum (inside the baby's mouth).
The Cross-Cradle Technique is the most commonly taught breastfeeding technique in Australia. If the mother is using her left breast, she puts her hand on her left breast and she would place her thumb just above the nipple and direct the nipple upwards. The baby would be held by the base of the head with her thumb and forefinger. The rest of the hand would travel along the baby’s neck and the heal of the hand would rest around the 7th vertebrae.
When we do that with a newborn or young baby, the baby is unable to move freely; it’s restricted. When it’s restricted it’s trying hard to release from that restriction. It needs to be able to turn, rotate, bob, seek, find, smell, taste and touch. With the heel of the hand on the 7th cervical vertebrae, it is my observation that it sets off the Morrow Reflex. You can only see one of the baby’s hand rise, because the other is often underneath. But the baby was almost trying to say “please don’t do that to me.”
The Cross Cradle:
With this happening, as well as the nipple to the baby’s nose and then the mother taught to wait until the baby’s mouth opens wide ‘like the Kellogs-K’ then the mother would try and time it so that she would wait for the baby’s mouth to be really wide and push the baby on to the breast.
She then held the baby there so the baby still can’t move. It’s still restricted. It’s very awkward for the mother because her upper body is twisted and many of the women complained of wrist pain, shoulder pain and lower back pain from doing this over a long period of time.
Observing these factors I realised something was wrong and to gain a better understanding I began observing other breastfeeding mammals. During this time I observed that mammal babies found their way by smelling, tasting and touching while self-locating the nipple.
The next step was to look at the underlying anatomy and I built models with a program called ‘Visible Body’ to help me develop what I needed and start putting the pieces together. I explored the cranium, the cervical spine and the intra-oral cavity and then it all came to me about what we were doing when we were holding the baby like that.
When we tip the nipple to the nose and when the baby hyper-extends, the nipple ended up in behind the corrugated area of the gum. It’s quite rough if you run your tongue along there. The tongue then tries to compensate and would actually grind the nipple into the roof of the mouth. I started to wonder if that was nipple tip damage because I was seeing damage on the nipples at different parts of the nipple at different extremes as well as variations of the trauma. I divided the nipple into 3 parts
The Nipple Tip
The Nipple Body
The Nipple Base
There was also the Areola because I was seeing other damage on the aerola that I needed to find out what was happening.
I started to think about doing what the primates do, so I asked the mothers would they like to change what they were doing if I came across this situation with nipple trauma, with engorgement, with mastitis, where the baby is being held in the Cross-Cradle hold.
With the elbows resting by their side, the mother’s hand would fall naturally on the baby’s back. Many women were holding the baby by the nappy and when they held the baby by the nappy it pushed the forearm forward, so again, the head was impeded coming to the breast.
So with arms comfortably resting, mother in a comfortable sitting position, not leaning back at this stage because if she’s leaning back she can’t sit at a shopping centre in public, or wherever she’d like to breastfeed. The hand falls naturally on the baby’s back and as each mother arm length varies, it doesn’t matter exactly where it falls. The baby rests comfortably on the knee, and is turned in gently to face the breast. Everything is gentle with the baby. It’s not rough, pressured, twisted or distorted. The baby is then placed gently against the mother’s body with lips over nipple and if you watch carefully, the baby knows exactly what to do.
The Thompson Method is based on ‘Mother-Baby Nurturing’. It is a gentle and intuitive approach to breastfeeding and requires patience and mindful observation from both mother and midwife.
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