On Wed, 1 May 2002 07:11:31 -0500, Jim & Winnie Mading <[log in to unmask]>
wrote:

>(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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There is a wonderful site that explains all about Ductal Lavage.  click on
the url to see http://www.susanlovemd.com/lavage_frames.html

Besides line drawings, there is a video to view.

Warmly,

Marguerite

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