I guess because I was the team lead at the hospital at the time reverse
syringes came out, there were never any at our bedsides. I was quite
cautious about them.  I'm not a big shield user either, but I do use them a
few times a year.  Reverse pressure softening is great, but I only find it
helpful if there is areolar edema. 

I know this sounds odd, but I've never had a mother stimulate her nipples.
By this I mean I don't have her pull them out or tweak them, which I find
many moms at the hospital doing when I walk in.  (I don't tell them not to,
unless I'm afraid they are tweaking those poor nipples too severely left and
right.  But I've never suggested a mom pull or tweak, either.)  Of course
the nipple does receive stimulation from having it stroked softly across the
baby's lips preparatory to The Latch. I figure the baby is nursing the
breast, not the nipple, and if the nipple has any protractility, it'll
happen when the baby latches.  And I want to take the mom's focus off the
nipple and put it on the breast. 

What I wonder is, in a nipple that in late pregnancy has shown little to no
protractility, and has not improved in the hours since delivery and the baby
for whatever reason can't take the whole nipple-areolar complex into his
mouth and breastfeed successfully, what are others doing to correct the
situation?  I've seen these situations correct themselves, and I believe
most of them can, but there seem to be only two tools for change other than
the baby:  the pump and the reverse syringe.  It would be a shame not to
correct a correctable situation.  I wonder if some people just use the
nipple shield for years-one of my clients graduated off her nipple shield
and said, "Oh, I'm so glad I don't have to wear that prosthetic nipple
anymore."

Arly Helm, MS, IBCLC

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