I have had the priveledge of assisting a mother with nipples as you describe through two babies. She was a young, healthy, mother with otherwise normal breasts. Lots of good tissue, and made plenty of milk. Unfortunately, she had these nipples that were about and inch and a half in diameter, and sort of like a flat ended light bulb. Her little ones were not quite so adapted to her nipples and caused her quite the erosion before she came to see me the first time, and she had been unable to nurse her previous infants, but was really motivated because she made lots of milk. I too expected to see some familial tongue tie or recessed chins, but they were beautiful. And then I saw those nipples. It took me a moment to recover my composure between the new erosions, the obvious damage from previous attempts, and the size. But I was highly motivated to help this highly motivated mum!

What we ended up doing was ordering the largest nipple shield I could find. A 30mm from Germany. She would put in in a cup of scalded water and then would stretch it out as much as she could, and then apply it, getting as much of the nipple as she could in it, and baby would nurse on the shield. Mum continued this until both babies were about 3 months old and then was able to wean them off the shield quite easily. With the second bub I helped her with, she did develope a blocked duct immediately postpartum, and that took quite a while to get situated because she had a thick callous in that area from all the previous injuries of babes unable to get the entire nipple in their mouth.

Angela Hartfelder IBCLC, RLC

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