Wasn't it someone here on Lactnet who coined that perfect phrase "Oroboobular disproportion?" This sounds like a textbook case. I have to ask or I'll toss-and-turn: I assume trying "every position in the book" includes laid-back by mom, prone self-attachment by baby ....? I'd suggest: *Until* baby's jaw and oral cavity grow a bit more, Mom may have to do a lot of hand expression during the feed-at-breast, while the baby is hanging off the nipple "nursing." Not breast compressions (which assume the latch is effective) ... but hand-expression, to (truly) help move the milk through and out of the breast. But there is so much nipple abrasion going on that this may not be a viable option. Can you get your hands on one of the largest sized Mamivac (I think that's the name....) nipple shields, from a Code-compliant German manufacturer? They have a nipple shield style that is more dome-than-cone shaped. The mom may find she can use a shield that will accommodate her large nipples, so at least she can have feeds-at-breast and avoid nipple abrasion, even though she is using a lot of simultaneous milk expression techniques. -- Liz Brooks JD IBCLC FILCA Wyndmoor, PA, USA *********************************************** 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