Another good discussion of this issue can be found in Vol 7 of Clinics in Human Lactation.
It is The Nipple and Areola in BrFdg and Lactation by Marsha Walker, RN IBCLC
She discusses the info in all the citations that Jean did, and discusses Jean's RPS method for resolving edema.
I find it to be an excellently referenced read / study / practice book. 
Phyllis

---- NicoLLLa <[log in to unmask]> wrote: 

=============
Thanks Jean, for the thorough history lesson; it is fascinating to see how perinatal "management" has "evolved". It explains much of what I experienced personally and have helped mothers with. But what really struck me in your post was this 

"The anatomy of the nipple and the areola are intimately connected from the time of their embryological development, and slow development of nipple inversion is normal at one stage near the end of the second trimester. Subsequent eversion apparently is still taking place even during the newborn period, and the Dubowitz-Ballard score for judging gestational age uses breast/nipple development as one of its criteria." 

I wonder if anyone has ever addressed this in relation to the breastfeeding issues seen in pre-term babies? Most of the information and research I have seen is about the infant's developmental readiness to co-ordinate suck/swallow/breathe. Is there any information or research out there on the readiness of the breast to be suckled? And whether there is or isn't, what are the possible implications for late pre-term or near-term inductions and elective C-sections?

Nicola Aquino, LLLCL
obviously in a questioning mood in the early morning
 

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--
Phyllis Adamson, BA, IBCLC, RLC
Glendale, AZ.
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