Allyson,

As an outpatient lactation consultant, I have women coming in telling me that they have had latch difficulties and that the hospital LC told them that it was due to their flat nipples. The problem is, when I see them, their nipples are not flat even though by then they have "owned" the label.  What I suspect is happening in these cases is that labor drugs are causing edema that flattens out the nipples temporarily, disrupting latch attempts by baby. RPS would be my first step if I were an in-house LC.  I explain to the mother that what the hospital LC saw was likely different than what I am now seeing, and why. And then we move forward.  So when it comes to what the OB offices are missing, and they don't all screen for such things, keep in mind that perhaps what you are seeing is *not* what they saw in the office. 



~Lisa Marasco, MA, IBCLC



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