Just met with a mom who pumped exclusively for her previous babies due to
*very* inverted nipples.  Deeply inverted at rest, more so when compressed,
and still didn't evert at all when I pulled back towards the chest in a
"nipple sandwich" move.  They did not evert with previous pregnancies or
after delivery; shells during (second?) pregnancy didn't help; used a
shield for a while w/ second baby; really wants to breastfeed.  We'd
already made the appointment for a prenatal consult when she found out
she's having twins this time around.  Talk about upping the ante.

She had an LC working with her quite intensively before, and they had
little or no luck.

I've told her this is to some extent a wait-and-see situation where it's
really important to focus on things like unmedicated birth if possible
(we'll see if the doctor will refrain from a c-section... but she did have
her other babies vaginally unmedicated), uninterrupted skin to skin contact
after the birth, *no* bottles/pacifiers, hand expression, *anticipating*
rather than responding to babies' cues (so she has a chance to bring the
nipples out a bit before they go orbital), lots of help, etc.
I have seen mild inverted nipples come right out and present no problem
whatsoever over a period of a day or so, when the mother coaxed a reluctant
nurser to the breast by hand expressing milk onto the baby's lips over and
over again.  So I would like to try something along those lines.

Any success stories, or warnings, out there?

Elise
LLLL, IBCLC

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