Hello Lactnet:
I am passing along a note I sent to Jean Cotterman after trying this
technique.  It softens the nipple-areolar tissue by means of firm steady
pressure, applied with the tips of the fingers around the areola (if one
has short nails), or with the sides of the fingers.  Press inward and
hold for 60-90 seconds.  Fluid is mobilized out of edematous tissue with
no pain to mom, and breasts become much more "latchable".  Check this out
for those moms who've had lots of IV fluids (and who hasn't these days),
and whose nipples are thick and non-elastic.

Jean,
I am so excited! i tried RPS today for the 1st time and it worked like a
charm!  (Yes, it is true, we old L&D nurses, just can't keep our fingers
off of things.)  I was called to labor and delivery to help with a 3 hour
old baby who was eager to feed but could not latch, and staff nurses had
tried to help, to no avail.  I spotted the IV bag, took a look at her
very rounded, full nipples, and went right for RPS.  Within 60 seconds,
there was a palpable difference (much softer)in her nipple and areola,
and no discomfort was caused (as sometimes is with hand expression).
With my assist, the baby latched on, and after ~ 15 minutes of on-and
off, he held the breast and sustained for about another 45 minutes! Mom
was able to re-latch him the one time he came off.  I am thrilled with
this technique, and am sharing it with my co-workers.  Can't thank you
enough.
Martha Johnson RN IBCLC
Eugene Oregon

PS for Jean: By the next day, staff nurses had given mom a nipple shield,
and with the shield, she was latching baby independently and developing
confidence in her and her baby's growing skill.  Not sure what happened
after, as I have been off work since.

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