My imagination is at work here again. I need to ask some questions.

Lisa writes:

<Looking for suggestions for a mother who is suffering significant nipple
pain due to one sided compression of the nipple itself.>

We are then talking pain, not visible damage? Is there pain while
feeding, or is there some suggestion of Raynauds color changes? Is there
actual pain while pumping, or just the appearance of the shape you
describe? If there is pain, is it from the underlying tenderness of the
nipple, or is it less than when the baby's jaw is doing the work?

< By this I mean mom's nipple has almost a "shelf" when everted->

I assume we are talking about a nipple with some degree of inversion when
not stimulated. Does the nipple appear "bifurcated", that is, sort of
divided horizontally by an indented furrow between a sort of semicircle
of part of the nipple body on top and part below? Does one of those
halves comprise the "shelf" you describe?

Or does the entire center portion seem to fold inward rather evenly? When
you slowly do a nipple function exam by compressing the fingertips 1/2 to
1" behind the base of the nipple at several different locations 90
degrees apart, what happens?

< one side of the nipple
rounds "normally" but the lateral side does not evert as high,leaving
a "peak and shelf" type look. This occurs whether nursing or pumping.>

It sounds as if the lack of eversion of that lateral side is due to some
cords that descended normally into the underlying tissue during fetal
development but did not complete their development in the next stage. Or,
less likely, some scarring of tissue on that side from some past injury
or infection.

Have you tried positions where the baby's upper and lower jaws/tongue are
placed 90 degrees further around inieither direction so that the forces
of compression are distributed differently?

You did not say how old the baby is. Is engorgement still a possible
factor? A few answers to the above question might conceivably supply a
few more pieces of the puzzle.

Jean
*********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html