Thanks to Jean for her thoughtful additions to my briefer post on the issue
of the baby who can't nurse.  The words we assign to the part of the breast
that the baby is drawing into the junction of the hard and soft palates is
another one of those indistinct, or fuzzy terminology areas.  We prob. do
need either a better word than "nipple", or we need to accept that it is a
shorthand term which does, of course, imply the nipple and underlying tissue
plus some areola.  This "teat" that is formed under suction (if mother's
tissue is sufficiently elastic to allow it) does extend to at least twice
it's resting length.  We have good evidence of this in the ultrasound work
of Smith, and also in Peter Hartmann's recent work.  I certainly agree that
better examination of the breast plays into the evaluation of why the
breastfeeding isn't working.  We have the dyadic interplay, and typically
there are contributions from both sides that influence success, failure, and
determine the sorts of compensatory strategies moms and babies employ.


Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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