Hello and Happy New Year to all! I need assistance in trying to figure out what is going on with a Mom and I have permission from the Mom to post this information to the list. Mom delivered earlier in the week, uncomplicated birth. She is of African descent. I assisted her with her last BF experience 2.5 years ago, and she exclusively pumped (for 6 months) and bottle-fed EBM. She experienced excruciating pain during suckling, despite a deep, asymmetrical latch. The baby had no oro-motor issues and Mom's nipple was rounded on release after suckling. In the beginning, she had sloughing of moderate amounts of nipple skin with pumping, and her nipple tips appeared quite dry despite the use of Lansinoh and EBM. She has very unusual nipple tissue which I have never encountered. Her nipple tissue is not dry as with her last baby. The tips of her nipples are large and almost have the lined appearance that a "Geographic tongue" does. When suction of any type is exerted upon them and her nipples elongate, the tips of her nipples appear to be constructed of feathery villi-like appendages. Pumping on low to moderate suction with the Symphony and extra large flanges is comfortable for her; however, when we tried a Medela shield, the pain of the baby suckling was excruciating for her. She reports that her nipples have always been somewhat tender, even when she is not pregnant. She denies any itching or burning of her nipples and the tissue is not reddened. My questions are: 1.) Have you ever seen this type of nipple anatomy? 2.) What besides anatomical variation would cause the nipples to be this way? 3.) Can you think of any interventions that might help this Mom? She is resigned to pumping with this baby also, but would really like a name for what she is dealing with regarding the nipple anatomy. Thanks in advance for the help! Tille Phillips RN IBCLC Charleston SC USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html