Hello fellow Lactnetters,
    A word of intro as this is my first post after many months of lurking & learning.  I'm a mom of 3, LLLL, and WIC peer counselor in Charleston, WV.  Also a professional oboist, but that's another story!  Anyway, I'm seeking your words of wisdom regarding a mom I saw today (who gave permission to post).  She has a 6 day old full term daughter, weighing just over 6 lbs.  Came to our office requesting bfing help because it was "killing her."  She showed me her left nipple, which was very large, probably larger than a quarter in diameter.  It was cracked vertically & scabbed over, looked really raw.  The entire breast was engorged, as she had not nursed on it for about 36 hours, just finding the pain unbearable.  Her other nipple is much, much smaller, and baby is nursing there just fine, and getting plenty, as she had 2 large bm's while I talked with mom!  Very contented after feeding.  She is leaking from the affected breast and had not yet tried any of the "usual" suggestions for engorgement.  I also called around the area and found a source for one of the large-sized flanges to go with her pump, which she was willing to try, even though I did tell her that pumping that side might not necessarily be any less painful than nursing on it.  She is using Lansinoh on that side, too.  I just wondered with the discussion we've had lately about what/whether OB's should say/do regarding prenatal breast exams, is there any documented evidence that having very assymetrical nipples can predispose mom to problems of this sort?  I really think that if she can preserve the supply in this breast until baby grows a little (oro-boobular disproportion???), that the baby will nurse fine.  I kept reassuring her that it was possible to fully meet the baby's needs using just one breast, as well.  Would welcome your thought and additional suggestions, privately or to list!

Jenny Morris, in windy, stormy Charlie-West!

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