The first thing that hits me is:  Does this baby have a Type 4 tongue-tie?  Check that out.   

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Pamela Murphy, PhD, MS, CNM, IBCLC
Sent: Friday, February 19, 2010 8:01 AM
Subject: Niipple shields-?longer tip

I am posting this on behalf of one of my colleagues:

This is a case of a mother nursing an ex-preemie (31 wk) who has been using an SNS and nipple shield with nearly every feeding for 3 months. The infant is now 3 months of age. I referred this case to OT, who determined that the infant had nearly no frenulum at all. Given the near absence of the frenulum, a longer bottle nipple is recommended for this baby. The mother wants desperately to wean from the shield and breastfeed without it, but this is likely impossible with a shorter maternal nipple. My question is "Are there any nipple shields available with longer nipple tips?"

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