In a message dated 97-02-17 10:19:30 EST, you write:

 I have a mom with exceptionally long nipples -- probably about 1 1/4 inches
 long & about 1/2 inch in diameter.  Baby has a short tongue (not a short
frenulum), and he simply  can't get back far enough on the areola to compress
the lactiferous sinuses.   Despite fact that mom is producing copious amounts
of milk, baby is taking  only about 1 ounce total from the br before moving
to "hanging out".  He
 LOVES to have the breast in his mouth; loves to suck, but isn't "eating."
  She religiously does alternate br massage to try & pump a bit more into
him.
  Ends up pumping and supplementing via cup or fingerfeeding.  >>

Hi Jan,
Every mother I have seen with looooong nipples like this has the same problem
with each baby, and it seems to get WORSE as their nipples get LARGER and
LONGER with each pregnancy and nursing.  The only cure I know of is "time"
and maintaining lactation with the pump until he "grows into the breast" then
breastfeeding progresses beautifully as long as mom and babe want.   She can
keep him loving to nurse, maintain her supply with the pump, and supplement
the milk to him via tube device or as she is doing with the cup, etc.
If anyone else has more suggestions I would love to hear them. This is so
frustrating. Some babies I've seen actually gag on the huge nipples  that
extend 1 1/4 inches or more into their mouth, and their jaws still can't
reach the lactiferous sinuses.  Some of these moms are  teeny-weeny little
women too!!
Jane Bradshaw RN, BSN, IBCLC