Tammy wrote:
<I suggested after watching the mother try to
latch not very successfully without the shield that she use breast shells
which I had to give her, to see if they could not draw out the nipples so
the
baby could latch more effectively. I think this will eliminate latching
problems and when the baby gets older he can nurse more effectively
also.>
Winnie's reply said:
<I've pretty much stopped recommending the shells. IMHO, the more mom
"needs" them, the less likely they are to stay "on target"! If they
don't remain centered exactly around the nipple, they can actually be
counterproductive. We suggest using a cut-off and reversed 20cc syringe
or the comercially available version, Evert-It (no commercial interest).>
What small help the shells sometimes provide seems to come from the
reverse pressure of the bra pressing the shell against the surrounding
areola.
I once saw a case where an inadequately instructed, very blonde mom,
mistakenly used the small opening section for prenatal use, leaving it in
her bra between feedings during the postpartum period.
It was very obvious from the cyanosis of the nipple, that circulation was
also being compressed. Fortunately, the cyanosis went away when the
shells were removed. Another "gizmo" that sounded pretty good in theory,
but disappointed in practice.
Reverse pressure softening done manually can have a positive effect in
this situation, by temporarily vacating even modest amounts of
interstitial fluid, and vacating the milk from the sinuses, thus leaving
the tissue more freedom to evert when the baby (or syringe, etc. as
above) is applied.
Anyone interested in further info can contact me privately. There is also
the Pigeon brand (no monetary interest) nipple puller which retails for
<$5 US.
I have a mother with this exact situation testing one for me at present.
I will ask her if I can share her impressions on Lactnet after things
begin going more smoothly for her and her week-old baby.
Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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