Fritzi,
When I see a mom, I usually teach her how to hand express milk (unless
she says she doesn't want to learn!).  In doing so, I have found a
handful of anatomic variations of the milk sinuses being set back much
farther than normal, which clued us in right then and there that the
(newborn) baby would *not* be physically able to compress them with his
gums.  I've used the unbelievably expensive glass flanges on hospital
grade pumps (both major brands) to effectively draw milk from these
sinuses until the baby's mouth was large enough to reach the
sinuses--took 4 months for one munchkin.  Mothers happened to be
incredibility motivated and either bottle fed or used SNS at breast or a
combo of the two.

I don't recall that there were any visible clues to these variations--the
breasts looked normal to me.

Karen Zeretzke, MEd, IBCLC
Baton Rouge, Louisiana
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