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Subject:
From:
Jim & Winnie Mading <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 1 May 2002 07:11:31 -0500
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(If I am stating something that's already been said, I apologize-a
little behind on reading LN)

Jan, How frustrating!  Why is it that the moms with physical barriers to
breastfeeding are the ones who want to and the moms with seemingly
perfect anatomy for nursing are so often the ones that don't want to
have anything to do with it?!

You mention trying a nipple everter.  Are you using the commercial one
or an adapted syringe (needle end cut off and the plunger inserted from
the "wrong" side).  I have found that the softer rubbed end of the
Evert-It is too gentle in some cases.  I have not used the Nipplette.
In some cases it seems the firmer edge of the syringe flange focuses the
pull better.  Depending on the diameter of her "nipple", you might try
both a 12cc and a 20cc syringe.  We find the 20 the best fit most of the
time.

If inverted nipples are caused by adhesions in the breast as some have
speculated, it would make sense that the adhesions may also "seal off"
duct openings.  If they are genetic, one might conclude that if there is
one anomaly, others in the same organ are certainly possible.

I have had some moms whose lactogenesis takes more that a couple days
and where we are unable to get ANY EBM for the same several days.  Was
she on MgSO4?  Is it possible that the initial fullness you noted is the
swelling that often accompanies the lactogenesis for a few days and not
the milk volume yet?  I would give it a few more days before concluding
that it's not going to work-possibly using a supplementer in the
meantime.  My theory is that the more different a mom's nipples are from
a bottle nipple, the greater the risk for possible "confusion".  While
waiting to see if she will be able to "deliver" milk, I would definitely
opt for cup feeding if baby won't take the supplementer so baby doesn't
catch on to the fact that nipples usually go back in the mouth.

An extreme thought:  I remember reading somewhere about a procedure to
test for cancer in milk ducts by skillfully inserting a needle into the
duct through the nipple pores.  (OUCH)  I can't quite picture how it's
done without puncturing the tissue-must be a somewhat blunt needle tip.
Could the same procedure be done (by someone skilled in it) to determine
if the ducts connest to the outside?  If that's possible, I even wonder
if such a procedure might "open up" the connections.

Please keep us posted-this is a new one on me.

Winnie

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