PTP
Moms third baby (8day old) and all had problems with latch/inadequate intake. She comes to me to try to avoid "the downward spiral" that occurred with other babies. 
Nipples Undamaged, erect, and areola elastic. No ties. Supplementing now with feeding tube, but just got an SNS
BUT her nipples are different than Ive seen. It looks as though a small grape was glued to the end of the areola. This nipple is not too small or large for baby, but baby latches on only to this rounded nipple. during observation of feed, she latches well onto this distinct firm nipple but no areolar tissue is grasped  I'm not sure how baby can possibly get more than this nipple in her mouth ! No wonder she transferred only 6ml with feed. 
Does anyone think a nipple shied could help in this circumstance? Just thinking it might help draw more of areola into her mouth.
Melinda Harris-Moultin ARNP iBCLC Olympia WA


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