Jacqui writes:

<if you put your 2 thumbnails together, back to back - her nipples were bigger than that. closer to 3 thumb tips.
i've encountered a good share of bulbous nipples, but nothing like this. 

mother reports that they really change during pregnancy and are more normal otherwise. they were both cracked at the tips, but not as badly as i'd feared. she appears to be a really fast healer based on the fact that she'd reported pumping almost all blood the day before i saw her and repeated attempts at latching and nursing did not cause bleeding when i was there today. she has one bleb/skin tag on the right nipple, as well. her breasts seem completely normal otherwise and went through normal lactogenesis. she had engorgement on days 3 and 4 which we relieved with reverse pressure softening w/ marked improvement. she leaked milk appropriately and baby tried to maintain latch repeatedly over the 2 hrs i spent with them, to no avail.>


I remember seeing at least one mother with such huge nipples, although her breast was barely a B cup. She said they had gotten bigger with each pregnancy/nursing. Her baby was several months old when I saw her. I have seen few since that even come close. However, since pumping is involved and she had a C.S. thus IV fluids a plenty, I did want to say that it is possible for tissue fluid to push its way forward in the pump flange and enlarge the nipple itself as a result of pumping. Rachel Myr told me she had a mother once on whom she used RPS or a version thereof on the actual nipple itself, gently, and for a slightly longer time, which temporarily moved some excess interstitial fluid out of the nipple itself, and back upward into the subareolar areas. It might be worth a try to see if it can temporarily reduce the
dimensions of the nipple before latching attempts. 


If nothing else, perhaps it might reduce the size enough that a nipple shield might somehow be placed over the nipple??? And if the baby would suck, breast compression might help the milk to flow, even if the whole nipple would not enter?? And if the baby ends up having to use a rubber nipple for feedings,  then it couldn't harm much as a last resort to try an actual silicone bottle nipple of a brand I will tell you privately since I don't want to advertise it.

<we tried every position in the book - even mom leaning over baby and dangling the breast into baby's mouth to see if gravity helped the flow and kept baby interested - but it's really like it's just way too much for baby -she latches on and then rejects it when it's too much for her to suck into the proper shape.>

I am curious about what gravity might do if you reversed the position. Have mom lie flat on her back with a pillow under her head and one under each upper arm. Reduce the nipple size as above if at all possible, and then let baby lie directly on top of mom so gravity might spread the breast out a little over the chest and the weight of baby's head would press on to the mother's breast, as at this age, perhaps her neck muscles are not quite strong enough to lift her head for very long??? If the nose is not free of the breast just move the baby's hips further away from the breast to tip the baby's head and nose into "sniff" position. 

Let us know if any of these suggestions helped, or definitely didn't help at all.

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC     Dayton OH

             ***********************************************

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