Has anyone ever seen nipples this large?  Mom had a 34 week preemie and has
the largest nipples I've ever seen.  She calls them "deformed" but I assured
her they're just a variation of normal.  She breastfed her last baby
exclusively with no problems and never used a pump.  Unfortunately this baby
is still in Special Care and is 4 pounds, definitely with "oroboobular
disproportion".  She pumped with standard flange and got some rusty pipe
milk the first 2 times (RN started her pumping and IBCLC did not see her
nipples).  She told me the next day she was not getting any milk anymore and
thought it was because her nipples were too large.  Boy, was she right.  The
left one measures 32mm and is bulbous.  I didn't measure the left but it is
even larger and oblong. I luckily had a 40mm glass breast pump flange on
hand and that was a comfortable fit.  Today her milk volume has increased
and it is not fitting well on the oblong nipple so she is having trouble
getting the milk out again from that breast.  We can teach her hand
expression.  She is not engorged or edematous.  Has anyone ever had a
similar situation and how did you deal with it?  I expect her to need to
pump for at least several weeks.  Do you think she'll be able to get this
small baby directly on the breast when he's ready to start feedings?  Any
suggestions welcome.

Linda S. Anderegg, RNC, IBCLC, RLC in Chicago    


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