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Hello Lactnetters,

I am working with the mother of a 1.5 week old baby.  Mother has very large breasts and very large (wide) flattish (as in they protrude a bit but minimally) nipples.  Until now, baby had not latched and has been fed a mix of EBM & formula via bottle (mom is reluctant to use a cup).   With using laid back positioning, teasing the nipples out, supporting moms breasts with rolled towels underneath, baby managed to latch, but it was just the tip and therefore excruciating for mom.  We also tried more assisted latching with trying to shape the breast for baby to get a mouthful, this had similar results.  Since nothing else was working, we then tried a shield.  Mom had purchased the 24mm medela contact shield.  It just barely fit over one nipple, but the other nipple was too large to fit in.  Baby did latch and nurse with the shield in place on the smaller side.  Though it was still painful for mom, it was tolerable and there was audible swallowing and other signs of decent intake.  I also suspect tongue tie and have referred mom, but the wait is several weeks, so we are trying to make the best of the situation until then.

Does a larger shield exist?  Any other suggestions for very wide nipples?

Thanks!

Jennifer Welch, IBCLC, LLLL
Montreal, QC Canada

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