Diane Wiessinger's post reminded me of some related ideas.  She wrote:
- "One possible source is a nipple that folds over inside the bra.  If a
crack at the base gets started, every time she "puts her breast away" the
nipple may fold at its base and stay wet.  I don't quite see how it would
fissure *all* the way around from that, but maybe if it folds differently at
different times?  Just wearing bra flaps down would take care of that."

A few years ago I saw a succession of mothers with circumferential cracks
that weren't healing.  Invariably, these mothers were wearing bras that were
a firm fit with a fashionably rounded shape over the nipple (and no extra
space), and they using totally flat, cloth breast pads.  They'd bought them
because they were sold by a breastfeeding organisation and so they assumed
they were the best.  With little enough space for the nipple in the bra
without flattening it, the flat pad further folded the nipple in on itself.
So the damage wasn't healing.  Some seemingly rounded breast pads (one of
the disposable brands) are actually flat on the inside and they have more
thickness than other brands over the nipple.  This thickness can press on
the nipple and fold it when worn in a firmly fitting bra.

Maternity bras are expensive and mothers are reluctant to replace them,
espec if they have chosen what they believe is "the best".  It was easier to
encourage them to leave the bra open, or leave it off at home and just wear
a baggy T-shirt, knotted under the breasts if support is necessary.  (This
was, of course, in addition to attending to the original causes of the
nipple damage.)

I tell mothers that the best use for the totally flat, cloth breast pads is
as a coaster to place under a drink - but keep them away from their nipples.

Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Private Practice Lactation Consultant (cohort of 1985) 
Brisbane, Qld, Australia 
E: [log in to unmask] 
 

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