HI all,
I have noticed that women's nipples lose tone and become wider with each
baby.  That seems to leave a lot of flesh that sort of telescopes over
the nipple--after many children.  So the baby has a lot of breast in
their mouth, but from a sensory standpoint and a milk transfer
standpoint little is accomplished.  I have seen this only a few
times...not too many multi-multips in the area.  My reaction to your
situation is that I sure would like to see her breasts and assess their
texture.  
Pumping, often single, so the mom can also do deep breast compression,
has been very helpful in establishing milk supply.  The baby actually
gets more breastmilk this way.  We have not had problems with nipple
confusion in these babies.  The moms may have to pump for 3-6 weeks, in
my experience, to establish a supply and by then, the baby expects and
extracts milk much better.  Very interesting phenomenon.   
Polly Kocher, IBCLC, LCCE

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