A coworker of mine visited a lady with the most peculiar nipples.  I will
try to explain and request feedback on treatment.
Second baby, nursed #1d for six weeks of gradually decreasing milk supply
and very painful nipples.  Very committed to nursing, baby is 2 weeks
old, gaining well, but being supplemented, no evidence of nipple
confusion or preference.  The breast is normal, the development through
pregnancy is normal.  The nipple appears normal, but when suction applied
a piece of the nipple, (Like the whole tip) EVERTS out is the best
description.  It is not a  dimpled nipple, the nipple protrudes.  The
problem obviously then is when the nipple flips out like this that entire
surface is raw and incredible painful, which she grins and  bears it.
When breastfeeding or pumping is over the nipple tucks itself away and is
painful.  There are not adhesions, it's as if the tip of the nipple
telescopes in and out.  We can't think of a way to make the nipple stay
everted ((for lack of a better word) or promote healing with it tucked
away each feeding.  I know this isn't the clearest presentation, but I
hope it piques your interest and someone has a suggestion.
Again, I thank you,
Robin Hollen RN IBCLC
Reno, NV