Hi Lisa,

Well, I'm going to stick the old neck out, gulp, and say something that I
will probably get jumped all over for....but it sounds as though Mikayla
might do really well with a nipple shield.  I had a case that sounds
virtually identical to yours a couple of years ago.  Christopher just could
NOT get on to the breast - same type of "playboy" tight taut breasts with
inelastic skin & flat nipples.  Unable to compress the areola at all or draw
the tissue into his mouth.  He happily nursed using the dreaded n.s. for 9
months, gained weight like a house afire.  The mom pumped for the first few
weeks to make sure her milk supply was adequate, but there was never any
problem, and she even quit pumping.  Christopher never did go to the breast
alone though mom tried frequently.  Her second baby she came to me during
pregnancy, we started with br. shells and massage of br. tissue.  She had a
darling girl who latched on immediately after birth and never looked back!

I'd suggest trying the nipple sucker/extender/adapted syringe first and see
if you get anywhere using that.  If not, you may want to opt for the n.s.,
especially if mom gets to the point of quitting.  I'd go for that before
prolonged fingerfeeding which is time consuming and the baby isn't at the
breast......

Jan B.