Hi Jennifer,
What I am picturing is what I call a bulbous areola, which I sometimes see
with breast hypoplasia. I think it is improperly developed breasts. I
searched "nipple hernia" just now and, not surprisingly, I found this as
the first search result, on a web forum. I think this is exactly what you
will find with the mom in question:

<<My nipples are very ahmmm, puffy and round, like there is no areola on my
breast it all just pokes out. He said that it's a hernia and can by fixed.
He recommended waiting until after my aug. and then doing it in the office
with local. My breasts are slightly tubular so I guess these things might
go together.>>

So the mother in your case, I think, will have a high risk for low milk
production, and therefore needs to do "all the right things" that we know
ensure best milk production, but will also need good education as to s/s of
problems and close followup in person. Would be a candidate for a lactation
aid.

Laurie Wheeler RN MN IBCLC
Mississippi USA

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