Sarah: I'd like to comment on your question about forming the nipple into a nipple sandwich. My experience has been that there are a lot of techniques to try, and some work for some babies, some don't, and you can never tell ahead of time which techniques will work. It's mostly trial and error. Sandwiches seem to work well with some babies who can't get a full mouthful. Sometime stretching the nipple by holding a tiny bit of skin on the side of the areola will help a baby who needs to feel the hardness of the fingers to get him going. (He'll nibble his way on) This will work on mothers with highly elastic skin and heavy breasts. Some babies need to have the nipple aimed up so that they can get enough of the breast tissue underneath the nipple in their mouths. What I am trying to say is that they (LLL and Ruth Lawrence) are both right and sometimes both may be wrong. It depends on the baby, the breast, and the situation. Both methods can result in less that optimal attachment, but frequently that attachment can be modified by position changes once the baby is on. (Pulling the baby's bottom or shoulders in closer to mom, lifting the breast etc.) Also, sometimes all these methods are too aggressive and you need to back off for a while and wait for the baby take the lead! Be creative. You might invent a new technique! Karen Koss in Brighton, MI [log in to unmask]