Lanell writes;
>>Mother has very large areolas (7-8cm), tiny nipple that
everts only slightly - somewhat large breasts.  Brings baby to breast and he
opens very wide to latch, but won't suck.
In the following days, he still hasn't latched on well, but weight loss has
been minimal.  At home on Day 3, breasts are VERY full, palpate milk in
both, but nipple is now flattened out and baby just won't latch, despite
help with positioning.  Helpful neighbor brought client a pump and SNS which
has worked for now.<<

If weight loss has been minimal than he must be getting something
I would agree with the use of the pump as a tool to facilitate latch ie. pump
for several minutes than try at breast but am confused by the use of the SNS.
Although I have heard reference to its use many times with latch problems, I
can't envision its use if the baby won't latch as it's correct use requires
the baby to be latched to the breast. Unless of course it's being used as a
straw to transfer milk.
You have a number of options here. I would definitely suggest a lactation
consult as there might be a subtle position change specific to the anatomy of
Mom/baby that could be a huge help. If Mom is unwilling, she could try a
nipple shield as she seems to have great milk and great milk transfer or she
could just wait it out with an alternate fdng method for EBM.
Your post also seems to suggest that you are placing some level of importance
to this baby's latch issue, on the large size of the areola.
Am I correct? This should have nothing to do with the baby's ability to latch
or transfer milk.
Good Luck!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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