I have a client who is having SEVERE nipple pain and trauma.   She has the largest, most fibrous nipples I have ever seen.  Her nipples are at least 4 or 5  cm across, and protrude at least 2 cm from the areola.  The baby cannot even get all the nipple in her mouth, let along a "large mouthful of breast".  Mom is currently expressing only and bottlefeeding the milk, as she is very traumatized by the amount of pain she was in (why do they always wait so long to come see me?!).  Her nipples have so much trauma from that poor baby.  

 

I have no idea how to get this baby latched back on after the nipples have healed.  Do any of you have experience with this?  Would a nipple shield offer any benefit?  I just don't know how to get this tiny babies mouth wrapped around this nipple. (oro-nipular disproportion in the extreme here.).    Meanwhile, mom is happy to express and bottlefeed, even long-term if necessary.

Tara Guy, PA-C, IBCLC
 		 	   		  
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