Susan-
If the nipples were moved there was lots of damage to the ducts.  I would
be inclined to start with the SNS almost immediately to keep the baby AT
the breast for comfort even if there is very little milk coming out.  In
a way this is almost like an adoptive situation.  Obviously the hormonal
changes after childbirth will create engorgement- but that will happen
even if the mother never tries to nurse the baby.

Sarah

Sarah Friend Barnett   LLLL, IBCLC
Bronx (New York City), NY  -  [log in to unmask]
" You are not obliged to finish the task,
 neither are you free to neglect it."       R. Tarfon