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Subject:
From:
Dany Gauthier <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 31 Jul 1997 07:41:25 -0400
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Hi Lactnetters!

I am always eager to respond to post about flat nipples or shape of breasts.
I am on a constant battle where I work to try to chnage everyone's idea that
it is not the mother's breasts or nipples that cause the problem, but the
ability of the baby to use an efficient sucking mechanism. I have seen many
babies with mothers who seem to have flat nipples do extremely well in
drawing those nipple out and other babies with mothers with elongated
nipples not be able to suck properly.

It sems it is mostly a combination of baby's sucking ability + shape of
mother's nipples, that seem to be the cause to poor latch on. I have the
most success with working with both mother and baby in these situations: try
to shape mother's nipples to facilitate latch for baby and try to teach baby
to pull out his tongue and open his mouth wide. Time usually does the rest
of the work for us.

As for flat breast. We usually have the most success by compensating for the
shape of the breast with positionning of the mather and baby in such a way
that the two pieces of the puzzle fit together. With breast that do not have
much breast tissu I usually have more success with a side-lying position
where the mother will be propped up on two or three pillows so that the
little breast tissu she has will be able to "dangled" with the gravity. The
thing I worry most about in extreme cases is: is there enough breast tissu.
The question that gives me a quick answer to this first question is: Did
your breast change volume during pregnancy? and Did you feel your milk
coming ina few days after the birth of your baby?

The most common difficulty I face at the hospital where I work are not flat
nipples, but breast that are too "tight". I mean by that that the skin is so
tighly wrapped around the breast tissu and that the tissu feels as if it is
in constant engorgement. Babies usually have trouble lactching on and the
breast "sandwich" is impossible to achieve. For baby, it is like trying to
take a bite in a balloon...Problem is present even if the nipple is
elongated because baby latches on only on that piece of nipple...

Even though that, as you can see from what I wrote, I do see problems with
some nipple shapes and breast shapes, I always try to see the problem as a
baby related problem, and I try to present as such to the mother and to the
care team. The way we "think" of a problem definitely changes the way we
work at it and its outcome.
Dany Gauthier, IBCLC
Lactation consultant at Ste-Justine Hospital, Montreal
Quebec
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