Dear Celestia,

        It sounds as though the mom has a flattish nipple on the right.
The reason nipples are flat or inverted is that there are adhesions
holding the nipple in.  The adhesions need to be broken, gently, so that
the nipple can protrude.  This can be pretty painful, if they are broken
by a baby's strong suck (been there, done that).

        Nipple extractors (such as the syringe method) can do this
without much pain.  Using shells, a gentle breast pump, and the
old-fashoned pulling and rolling (hoffman's technique) can all help to
pull out the nipple and break the adhesions.

        Meanwhile, forget the warm compresses on the right.  Go with
cabbage and pumping to reduce the conjestion and drain the breast.  Once
she's more comfortable, maybe baby will latch and nurse on that one.

Good luck!


Margie Forrest RN, BSN, IBCLC in WPB, FL