Hi all,

I have a new mom w/ bilateral true inverted (invaginated?) nipples.  I'm
actually not sure what to call them.  There is nipple tissue that arises from
the areola, that is basically flat, but comes out slightly when she pumps or
uses a nipple everter.  However, the center of the nipple is creviced deep
down, and I'm unable to get it to pop out as most inverted nipples do.  If I
work behind the nipple a bit, and try to spread the opening apart, I can see
where the tip of the nipple is, but cannot get it even to the level of the
outside nipple tissue.  Imagine a straw with something stuck in the center a
millimeter below the edge of the straw....but this straw keeps shutting, so
that you have to pry the edges apart to see what is stuck in there.  (Bad
analogy, but I'm not coming up with anything else.

Mom had a primary planned C/Section two days ago.  We started her pumping and
using the nipple everter.  Today her breasts are much fuller than yesterday
with firm areas -- one might say it appears that milk is 'coming in.'
However, we are unable to obtain even a HINT of dampness from either breast
-- not with the pump, not with hand expression, not with the nipple everter.
Not a drop.  Nothing.

My question is, has anyone ever had a mom that had this condition, and
seemingly with no openings from the ducts (if there are any) to the outside.
No nipple pores.  I can't find anything in the literature, and I've looked in
a lot of spots -- obviously not everywhere -- though Lawrence says that a
woman w/ true inverted nipples has fewer ducts and that on microscopic exam
they do not look normal, but she doesn't explain what that means.  I'm
certain I read somewhere, but now can't find it, that inverted nipples are
associated with breastfeeding failure (and not just because the baby can't
latch), but perhaps I'm imagining it.

Anyone else have an idea?  Have you had a mom like this?  In my 17 years,
this is a first for me.  Maybe I'm jumping the gun in making an assumption
that there are no nipple pores....I hope I am, and that when I go in tomorrow
she'll be pumping out buckets and the baby will be nursing like a champ.

Thoughts?

Jan Barger, RN, MA, IBCLC -- Wheaton IL
Lactation Education Consultants
www.lactationeducationconsultants.com

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