I have had some success with mothers with large nipples by using a nipple
shield that is a little bit too small, so that it actually compresses the
nipple and makes it easier for the baby to take. This doesn't seem to be
painful for the mothers, and the babies have generally done well in terms of
transfering milk. If this doesn't work, or if the baby is still not
transfering milk well, then I'd suggest pumping or hand-expressing as well
(or instead) and feeding the baby with alternate methods.

Teresa Pitman

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