Jacqui,

I had a client once with nipples similar to what you describe, though
perhaps not quite as large as three thumbs.  She ended up exclusively
feeding at breast after a few weeks of pumping, because mom and dad
believed what I said about babies' mouths growing if you find some way to
feed them (just as you have informed your client).  Later, her complaint
was that her baby didn't want to take the bottle -- I wonder if he found a
bottle nipple too unsubstantial after getting accustomed to his mother's
nipples!

I think Jean's idea about having baby above mom is worth many tries -- more
than this family imagines.  LLL's handout
http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/01_laid_back_breastfeeding.pdfis
great for getting across the idea that biological nurturing (love that
term, too!) is about enjoying your baby and giving baby the chance to get
acquainted with your breasts on baby's terms.  I know I would want maximum
control over position and flow if I were that baby!  I'm curious about how
Jean's other ideas might work.  And I'll be eager to hear what your client
determines works for her family.

Sometimes the most helpful thing is to emphasize to mom and dad what they
achieve by a program of frequent pumping and and frequent biological
NURTURING.  I consider it a great investment by and for the family, no
matter the final outcome, for  baby to get as much of her mom's milk as
possible, for mom to lactate as long as possible, for mom's lactation
hormones to be boosted by baby's closeness, and for baby's growth-promoting
hormones to be boosted and stress hormones be suppressed by mom's
closeness.  If and when the convenience and other benefits of direct
breastfeeding kick in that's wonderful (and especially helpful since they
have an older child), but meanwhile your confidence that nipple morphology
and milk supply are just two components of the mother-baby interaction can
help parents focus on evidence-based parenting.  Your encouragement, and
help with effective and convenient pumping, are just what she needs!

Speaking of which, what do other Lactnetters tell moms (and hear from moms)
who are exclusively or mostly pumping about how often they rinse, how often
they wash with soap and water, and how often they sterilize the
milk-contact parts of their pumps?  I have pointed out to moms that they
can switch out bottles and refrigerate empty flange/valve/bottle assemblies
to keep microbial growth down between closely spaced pumpings.  If the
flange is detachable, it can be easily (unlike the valve portion) washed
(or wiped with an approved wipe) and stored at room temperature so mom
doesn't start pumping with something cold against her skin.

Ruth

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome