I would highly recommend closeup photography from many angles, both to seek
consultation on this case, and to follow what happens, no matter how it is
handled.

I had a mother with severely invaginated inverted nipples whom I followed
closely this way. At 37 weeks, a careful protocol was begun (with her MD's
permission) using a double electric pump to attempt to evert her nipples.
Within a week, for moments at a time, the nipples everted and it was evident
that one had a large skin tag at its base, which appeared to be in a
precarious place with a potential for damage.

As luck would have it, she had previously been employed by a plastic
surgeon, and was amenable to a consult to have it removed. She had second
thoughts and cancelled the appointment, concerned that if labor began before
her EDC, the unhealed scar might be a worse risk. With further help at
eversion, by term, she went on to breastfeed without problems with the
nipple, despite the large skin tag.

I think it is fortunate she was from a culture and a family where
breastfeeding was taken as a matter of fact. Her up-beat comment after
initiating breastfeeding was "My baby's not choosy. He will latch on to
anything!" Other mothers would easily be very sensitive to anything out of
the ordinary and be discouraged that they were "abnormal" and be likely to
give up the idea of breastfeeding. It demands great sensitivity and
attention to semantics on the part of the HCP to avoid such an outcome.

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

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