In a message dated 3.8.03 9:58:47 PM, Nancy writes:


> super-plus sized woman with extremely large breasts.  Complicated by:
> c/section birth, severe edema (taking HCTZ), very large nipple faces the
> size of a quarter, with thick meaty tissue there, and the nipples,
> unfortunately, are completely flat.  Baby is willing to try, but cannot
> grasp and form a teat.  Have tried all the usual tricks
> 
Good God Nancy this sounds like a tough one!
A few thoughts,(at the risk of being redundant)
Stick with the nipple shield, I think its your best bet at this point, 
especially in light of Mom's physical limitations. I imagine that it is the 
*meatiness* of the tissue that is presenting the biggest obstacle in 
achieving a real latch with the shield. This should improve with pumping.
 I might also try a reverse syringe, immediately prior to shield placement 
and intermittently. It is easy for Mom to use and effective. Blanket rolls 
(towels or whatever)under the breast and lg enough to lift Mom's breast 
should help with maneuvering it all.
One last thought, Is baby being fed well enough to give him the energy to 
really help with this?
Good Luck!

Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts


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