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Subject:
From:
Tille Phillips <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 6 Jan 2006 15:54:18 -0500
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Hello and Happy New Year to all! 
I need assistance in trying to figure out what is going on with a Mom and I 
have permission from the Mom to post this information to the list. Mom 
delivered earlier in the week, uncomplicated birth.  She is of African 
descent.  I assisted her with her last BF experience 2.5 years ago, and she 
exclusively pumped (for 6 months) and bottle-fed EBM. She experienced 
excruciating pain during suckling, despite a deep, asymmetrical latch.  The 
baby had no oro-motor issues and Mom's nipple was rounded on release after 
suckling. In the beginning, she had sloughing of moderate amounts of nipple 
skin with pumping, and her nipple tips appeared quite dry despite the use 
of Lansinoh and EBM.
 
She has very unusual nipple tissue which I have never encountered.  Her 
nipple tissue is not dry as with her last baby.
The tips of her nipples are large and almost have the lined appearance that 
a "Geographic tongue" does.  When suction of any type is exerted upon them 
and her nipples elongate, the tips of her nipples appear to be constructed 
of feathery villi-like appendages.  Pumping on low to moderate suction with 
the Symphony and extra large flanges is comfortable for her; however, when 
we tried a Medela shield, the pain of the baby suckling was excruciating 
for her.  She reports that her nipples have always been somewhat tender, 
even when she is not pregnant.  She denies any itching or burning of her 
nipples and the tissue is not reddened.
 
My questions are: 1.)  Have you ever seen this type of nipple anatomy?  2.) 
What besides anatomical variation would cause the nipples to be this way?  
3.) Can you think of any interventions that might help this Mom?
 
She is resigned to pumping with this baby also, but would really like a 
name for what she is dealing with regarding the nipple anatomy.
 
Thanks in advance for the help!
Tille Phillips RN IBCLC
Charleston SC USA

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