Jay, what did this mother's nipples look like before she started
breastfeeding? I ask because these fissures sound a lot like a description
I could have given about the nipples of a mother I worked with a couple of
years ago. She had 'dimpled' nipples, which is to say the tip dimpled
inward, actually not a dimple but almost a smile. There was an invagination
at the tip of both nipples which proved to be quite long, so that when
baby's suckling drew the nipple out, the invagination was stretched to the
tearing point. Immediately after feeding you could see an area about the
size of a thumbnail at the nipple tip, which was without epithelium. It
looked dramatic but was not painful to mother after the first couple of
days. Once she was reassured that it would not harm the baby, she continued
BFing happily, and to keep the fissure from adhering to itself between
feeds, she applied anhydrous lanolin salve to the skinless areas and covered
her nipples with Norwegian limpet shells. Diane Wiessinger sent me some
dimple nipple rings Chele Marmet had devised to keep dimpled nipples from
collapsing into themselves, but they were sized for much smaller, pointier
nipples than the ones I was confronted with.
I only followed her for a couple of weeks post partum. Three months later
she phoned, to report triumphantly that she now had two normal nipples and
had retired the shells and stopped using the lanolin. Slowly, the open
areas had been covered by new epithelium. I believe that the regimen of
moist healing and mechanically keeping the fissures open was key to this
development.
Her first course of BF was much shorter than planned: about a week, ended
when she got a bad mastitis, probably due to the aforementioned fissures,
had no help, and was so sore she couldn't bear it. This was her second
baby. Her very cautious goal was to stick with it for 3 months. Of course,
that was when it was just starting to be fun, so she decided to keep going
for another 3 and then stop. By 6 months she was still going strong and
decided to keep on for yet another 3, and by then she realized there was no
reason to plan ahead for weaning so she just started to relax and enjoy it
all the more. This I learned when I bumped into her at our local airport
one day. I don't know when he finally stopped (if indeed he has).
Of course I would want to rule out a stubborn bacterial infection in these
sores as well, but it could be an anatomic/mechanical problem.
Rachel Myr
Kristiansand, Norway
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