Amy: My subject header sounds kind of bizarre...Anyway, I have a few
suggestions.  Have you tried using ice to make the nipples erect?
Sometimes it helps.  Pumps can make the areola swollen if not used
properly; thus, making the inversion worse.  There are some other things to
try such as persistent use of very deep breast massage with arnica and
calendula oils to help loosen fiberous breast tissue.  This is done several
times a day and takes some getting used to for those who aren't used to
such vigorous touching of the breast.  Breast compression (ala Dr. Jack
Newman's handout) is a great technique to increase weight gain. It is done
during feedings.  Also, remember to suggest non-feeding ideas for weight
gain such as skin to skin contact, baby-wearing, infant massage and
so-sleeping.  To bring out inverted nipples and build milk supply, ome
mothers have had great success with a technique that is not endorsed by
either LLLI or ILCA...borrow a larger nursling who knows what he's doing.
I know, I can just hear the gasps...just be glad I didn't say it on Leeza
or in Time magazine (just kidding).

Reassure the mom that even with severely inverted nipples, babies get much
better at grabbing more areola as they get older.  Thus, baby will
partially grow to be able to stimulate the lactiferous sinuses and
simulataneously pull out the nipple.  Even though this is "genetic" please
assure the mom that her family line would most likely have "died out"
through natural selection if her breasts or nipples were not adequate.  In
the past, the baby sharing/borrowing technique was the PREFERRED way to
deal with this situation.

: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC  email: [log in to unmask]   : )
: )HSR & Health Educational Consultant        voice/fax: 541 753 7340    : )
: )LLLLLLLLLLLLL**CHANGE THE WORLD, NURTURE A CHILD!**LLLLLLLLLLLLLLLLLL : )