Today I was asked to talk to a mother who was having trouble getting her
baby, a few days old, to latch.  She has been pumping and cup feeding.  I
was forewarned that she had very large fleshy nipples, non-compressible and
too big for baby to get mouth around.  The mother had requested a shield to
see if baby could attach to that.

On inspection her nipples were obviously too big for our shields, and they
were indeed non-compressible and seemingly fleshy.  She had pumped not long
before.  Baby was interested in nursing.  I agreed to help her try a shield,
and showed her how to apply it by turning it inside out and then right side
out again, to draw the nipple into it.  Before we could do this, her nipples
needed softening.  Her breasts were otherwise entirely soft, but we tried
Jean Cotterman's RPS principle, applying gentle inward pressure with
mother's fingers directly on the nipple.  After less than a minute, her
nipples were soft and pliable, dripping milk, and she could easily apply the
shield - but she didn't need to, because now the baby could latch on and
nurse happily and effectively without it.  The fleshiness was edema,
exacerbated by the swelling caused by her rather large nipples being drawn
into the standard size pump flange, also the only one we carry.

Please, if you work post partum and have not incorporated RPS into your
repertoire, read the posts on it and start using it!  I shudder to think of
all the time I have spent in my years of practice, doing things that are
less effective but more time-consuming and requiring miscellaneous props, to
reduce engorgement and make it possible for babies to latch.  Now I use RPS
as the first choice.  Only rarely is anything else necessary.  It is like
MAGIC.

Rachel Myr
lazy (hate going to find shields) and stingy (trying to trim our ward
budget) in Kristiansand, Norway

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