Lori Salisbury wrote:

Winnie Mading <[log in to unmask]>> I find that Jean C's Reverse
> pressure Softening,which is much like the Hoffman's technique that
has been
> suggested for flat nipples, immediately effective.  It pulls the
fluid away
>

Winnie- could you please describe this reverse pressure softening?

I had already sent a response to one individual who asked the same
question, so I'll send it to you and the entire LN group

I suggest you try searching the Lactnet archives over the last 9
months or so.  I think that's when she first described it.  Try
searching
under "areolar edema" or "reverse pressure softening".  It is
basically the same as the Hoffman's technique which used to be
recommended for flat nipples, but seems to have been discounted in
some recent research.  In case you haven't heard of that, the
method is something like this (much easier to show than to
describe).
1. Press your fingettips (this can be done by mom or the LC showing
her) against the areola at the base of the nipple.  I find using the

index and middle fingers works best.
2. Gently slide the fingertips toward the outer edge of the areola
pressing in gently.
3.  Rotate the finger position to another area around the nipple and
repeat until entire areola has been "stroked" in this manner.
If the problem is areolar edema, you should see an immediate
difference.  Until mom's entire body has accomplished the postpartum

fluid shift, the areolae will "refill", but the edema will stay away
long enough to get baby latched.
In addition to "newly flat" nipples, other indications of areolar
edema are:
1. Areola appears raised above the surrounding skin (although this
profile may be normal in some moms)
2. Hair fillocles on the areola are indented giving a "pitted" look
to the surface
3. There is a "leathery" feel to the areola.
Hope this helps.
Winnie Mading, RNC. IBCLC

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