Saw a mother-to-be yesterday (G1) who was concerned about her "weird" nipple.
She wanted me to look and see if I could tell if it would work or not.  On the
left breast the left nipple is actually a cluster of three nipples--picture a
three-leaf clover.  One nipple is larger than the others, one a little
smaller, and one maybe 2/3 the size of the larger one.  All three look like
working nipples to me.  The larger two definitely seem to have pores.  The
right breast has one nipple about the size of a nickle; there is a dark line
disecting the middle of the nipple--could be a fissure but is very, very, very
shallow if it is.  It also appears to be a working nipple.  Nipples on both
breasts are a bit flat--the room was cool and none of the nipple were
erect--but definitely not inverted looking (although I did not ask the mother
to do the pinch test at this point).  Breast tissue both breasts appears
normal; no big differences in either breast aside from the nipples; breasts
have gotten slightly larger during pregnancy.  I did tell the mother that I
had not seen a nipple like the one on the left before but that what I saw
looked to me like it would work just fine.

The mother is concerned that she may in that very small percentage of women
who can't breastfeed.  She has a friend who is also pregnant and the friend is
leaking already.  I assured her that it is quite normal for some women to leak
during pregnancy and equally normal for other women not to leak at all during
pregnancy.  I did not want to do anything to undermine the mother's confidence
any more than it already is.  Therefore, did not suggest any apparatus at this
point.  (She is due in February.)  She is very modest--took her eight months
to work up the courage to ask me about her nipple and she is a co-worker!  (I
would actually like to take a picture of the nipples but I don't dare ask her
at this point; maybe later on.)

Anyway, I will check the nipples again in a couple of weeks to see if any
changes have occurred--i.e., more erect, any signs of leaking, etc.  I
hesitate to suggest breast shells at this time both because the cloverleaf
nipple(s) won't fit in the small holes in any of the models I know about and
because the mother has very, very low self-esteem already.  Question: Would
the ring attachment on the breast shells suffice to help the cloverleaf
nipples protrude?  Bear in mind that I am very, extremely hesitant to use
anything with this mother because I'm afraid that any device will undermine
her confidence.  I've alerted the Peer Counselor about the situation and
either the PC or I will be spot on to help the mother immediately after the
birth of the baby if any problems do occur.  But we are going forward with the
idea that, even though different, the nipples are all working models.  Any
knowledge to the contrary out there?  I'll keep you all posted.  And, as
always, tips, suggestions, info from anyone who has seen such nipples will be
welcomed.

Happy New Year to all and to all peace and prosperity (however you define it)!

Keitha Whitaker, BS, IBCLC
District IX WIC Breastfeeding Program Coordinator
Mississippi State Department of Health
email at work: [log in to unmask]