In a message dated 8/29/2013 3:07:37 P.M. Eastern Daylight Time, Pat  
writes:

culture,  prenatal dx that something is wrong, easily  available 
alternative -  all are significant in R/T to outcome.  If  you live in a country where 
formula cost is prohibitive or unavailable you are  going to want to BF 
over all obstacles.  If you live in US, then oh well  it is a lot of trouble, 
here give a bottle.
 
Hello all,
 
Pat you raise an interesting idea: are flat or inverted nipples "something  
wrong" or are they a potentially different, perhaps a little more 
challenging,  variant of normal? Are they a birth defect? Are they a difference, 
which may  give a mom information that helps her avoid or overcome challenges in 
the early  days?
 
In a culture of breasts as sexual objects, and where formula is considered  
freedom, modernity, entitlement, necessity, etc, how we view nipples that 
are  not perky and everted becomes more complicated. Whether it is a mild 
tongue  restriction that may or may not have functional implications short or 
long term,  or a flatter nipple that may or may not have functional 
implication short or  long term, it seems these variations can be seen as something 
that information  can help work with, or a reason to lack or lose confidence. 
It may not be  correct (embryologically speaking), but I might use the ole 
Muggsy Bogues story.  The generic version of this is: when you are walking 
down the street with a  friend who is a foot or two taller than you, your 
legs are going to move  differently, and may have to work harder to keep up 
with your friend. This does  not mean that there is anything wrong with your 
legs, but your friend may have  to make some allowances, either at first, or 
even over time, so you can  walk together. ( Muggy was a terrific player in 
the National Basketball  Association for 14 seasons, who was only five feet, 
3 inches  tall [ 1.60 meters], the shortest player even to play  
professionally. ) Now I'm not sure, but I hope that perspective might help a mom  to 
both know that something is different, perhaps a little harder, but to be  
creative, feel supported,  and keep working together on getting to a  smooth, 
effective comfortable, enjoyable breastfeeding relationship, despite the  
challenges.
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA
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