Hi All,

 

I am working with a mom with a situation I have not encountered before and
need some ideas.

 

Mom has very large, pendulous breasts that look like all the tissue is in
the bottom of the breasts.  The breasts are soft a 'squishy' - no firmness
to them at all.  One nipple was diagnosed as flat in the hosp, the other is
inverted.  Baby can latch well and get a great milk transfer on the,
so-called. Flat nipple (I don't think it is.but whatever).  The inverted
nipple is too frustrating for baby - it just runs away from him when he
latches.  Mom's mom is a long-time LLLL (30yrs!) very knowledgeable and did
beautiful work with mom trying several different holds including the
'inverted nipple hold' - no luck.  So, we tried a nipple shield.  Baby
latches onto the nipple shield without a problem EXCEPT:  He cannot get a
deep latch because the breast is so soft and squishy that when he latches
everything just sinks into the breast and all he can get is the nipple.  We
tried different hand positions to try and get more 'firmness' and tissue for
baby to latch on to - but no success.  If mom compresses the breast too much
the nipple runs away and nearly pops off the shield and baby still can't get
a good latch.  We tried a firm U-hold with compression far back from the
areola so there was no running away of the nipple, but, when baby latched
everything (baby and shield) just pushed into that soft, soft breast.  He
got a whopping 3 tenths of an ounce after 20 minutes of nursing - he was
happy at breast but I think we need a better milk transfer than that.  :-)  

 

Any thoughts?  Any ideas?  I have never worked with a mom where the breast
was this soft and baby could not get an effective latch with a shield.  What
she is doing now is feeding baby fully on the other breast (milk supply is
better than great!) and pumping to maintain a milk supply in the breast with
the inverted nipple.  I figure time, pumping, wearing inv-nipple shells will
help draw that nipple out enough for baby to finally get a latch without
having to use a shield.but it would be better if we could figure something
out sooner than that.  All ideas are welcome.please respond privately as
well as to the list.

 

Thanks in advance!

Jaye Simpson, IBCLC, CIIM


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