Maybe the baby is clamping down on the areolar tissue with a narrow gape and when mom has let-down milk does not push on through to the baby.  Try baby forward and face down, like sitting at the soda counter going for a big shake, keep the nipple pointed way up and almost folding into the mouth so gumline gets further back on the sweet spot.  Otherwise, baby may have to "grow into" the nipple/areola. 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of karen doering
Sent: Wednesday, June 23, 2010 9:15 AM
Subject: Insufficient milk transfer

I have a client who appears to have an adequate milk supply, based on pumping, but the milk transfer with the infant at breast as verified by an ac/pc weight is insufficient. The areolar tissue is very soft, "mushy", loose areolar complex? Could this be complicating the situation. Infant was full term, healthy, vigorous at breast, oral anatomy not an issue. Any thoughts?



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