Pamela, Thanks for your reply. We seem to agree very much on the management of these babies. As I recall the mom had what I would call soft or flattish nipples (nipples are never really truly FLAT, are they?). And what I usually do is "let's see if we can express a little colostrum?" and when I do almost always the areola contracts some and the nipple firms up and I say, "see how that makes your nipple more firm?" and I drip it on the baby's lips. I also showed mom the nipple sandwich technique which I, like you, use and find very helpful. She did have elastic tissue which was easy to shape. To the other question, I don't know if she rec'd stadol. Laurie Wheeler, RN, MN, IBCLC Louisiana Breastfeeding MediaWatch Campaign Violet Louisiana, USA mailto:[log in to unmask] ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com