Cindy wrote:
>I have just had my first case in 8 years of severely inverted nipples.
>Mom s first baby, has been wearing nipple shells and doing Hoffman
>Technique at the direction of her midwife for the last 10 weeks, del vag
>2 days ago. Nipples are truly and severely inverted. Have tried pumping
>with hosp grade pump prior to nursing

Did nipples evert with the pump? If so, baby will be able to do this also
eventually. Also it's early days, milk is probably not in yet. Try to make
sure she doesn't get engorged - keep using the pump if necessary. Try to
avoid more artificial teats.

and have tried SNS today, baby
>will latch briefly and suck 4 - 8 times consecutively but cannot stay
>latched. He has received one rubber nipple of sugar water due to a low
>blood sugar . Have tried sprinkling sugar water on moms nipples to
>entice him there, the sugar water will actually pool in the dimple in
>the center of her nipple. Tried a nipple shield today and baby would
>suck on that , we pulled it away after he sucked a little and he did
>latch briefly to the breast. Baby has a great root suck reflex, he just
>cant find anything to latch onto. Mom really wants to breastfeed . . . .

What happens if she continues with the nipple shield? Is baby getting milk
and everting the nipple into the shield? If so, it may help to continue
with the shield, with frequent attempts on the bare breast after initial
sucking on the shield, but not the point of frustration. It is quite likely
that this baby *will* develop the strength in his suck, combined with
increasing protractibility of the nipple, after a while, so he can be
weaned off the shield. It may take a few weeks. Just make sure he is
attaching to the shield 'properly' and not just hanging off the end like on
a bottle teat. Sounds very positive to me - with good rooting reflex,
willing baby, determined mum, etc. I have seen it happen. Often one nipple
is better than the other and baby manages to 'get it' with one but not the
other - still can feed totally with one breast if necessary. Keep
encouraging her, and monitor baby for adequate intake.

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Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
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