# Can we talk about flat nipples for a minute?



## veganmamma (Sep 10, 2002)

I have a doula client who didn't breastfeed her first because of lack of support and flat/inverted nipples. She's dedicated and ready to try again. Please share your stories with me!


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## Gidget (Aug 31, 2002)

I am not really sure how mine fits in. And it probably is not what you are looking for. Before I had ds1 I think my nipples may have been inverted. Rather than having them poke out at the end of the areola,there were little inverted slits there. The areola poked out in a cone shape though so he was able to latch on and drew them out. Sorry, I didnt have any trouble with it so I cannot be more help.


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## Marco Esquandolas (Feb 4, 2003)

I had inverted nips. I had to have an IBCLC come to my house after a few weeks of severe pain to see why it hurt and what I was "doing wrong". Now, I didn't know they were inverted (ya know, headlights came on when it was cold and whatnot, lol) until she came and checked them out. My advice? Be HONEST with your client. If she's determined to do it this time, it WILL hurt. Her baby will literally stretch the tissue out by sucking and that is the only way (aside of pumping and using those shields...or is it the shells...I always confuse the two, to help draw them out) to permanently draw them out. It will take time. It took a good two months before bf'ing didn't hurt and we both weren't crying at feedings. She can do all the stuff-never ever ever get engorged, let them air out after feedings, do both sides each feeding, feed more painful side first, wear whichever one (shields or shells) that helps keep nips erect, pumping, and RELAX, relax, relax for feedings. I toughed it out and it did get better, to the point that bf'ing just became the pleasurable experience it is supposed to be....with him and both his younger brothers. I hope she can stick it out (ha! literally) b/c once the tissue is stretched out, the pain goes away. It is sooooo painful until it does, though. Give her a







for me!!!!


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## ShadowMom (Jun 25, 2004)

I have flat nipples and consequently had latch issues. However, I met with a LLL leader and she showed me how to present the breast properly (ie "sandwiching" the nipple) and I haven't had problems since then. It just took me a little practice because baby doesn't know where to latch on, since it's more of a flat surface (nothing to grab on to). That's why sandwiching helped me.

HTH!!


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## wombat (Nov 3, 2002)

I'd heard of inverted nipples because a friend had them. I knew I didn't have them. But I think I do have 1 slightly flat nipple. It never stuck out as much as the other one.

And the terms 'flat' and 'inverted' get bandied around as if they are the same thing. They aren't, are they?? I had lots of trouble finding info on flat nipples. I had bad pain on my left nipple for the first 6 months - the skin around the base would literally redden, harden and peel off every few weeks. I thought it was dd's latch for a long time (it was, but that wasn't the only factor).

And I've never seen photos of flat nipples online either so I never realised I had them until I had pain for that long.


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## karlin (Apr 8, 2004)

I had flat nipples as well (although not "truly" flat as they would stick out a bit if I was cold). My ds had latch problems for awhile (and nipple confusion thanks to the nurses in the NICU...but that's a whole other issue). I pumped for him for 3 weeks before he finally latched on. I think a combination of pumping and a bigger mouth made it possible for him to latch. Pumping really did bring my nipples out a lot more. Although he did have a hard time latching for awhile after he first latched, we never gave up. It did hurt for a few weeks, but it got way better and way easier.


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## veganmamma (Sep 10, 2002)

Even inverted nipples salute for cold. Just so everyone knows, even the truest of true inverted nipples can stand at attention. It is adhesions taht prevent it from being pulled back into the back of the mouth that make the problem, and the adhesions have to be broken bt nursing. Pumps and shells will work to break some adhesions, but nothing like nursing.

I ahve a flat, inverted nipple on one side and at point basically stopped nursing from it. When you have two, that isn't an option!! Over time it drew out but my breast is still smaller on that side. It was vanity that convinced me to keep trying, since I had a b cup and a D cup









Keep 'em coming!!


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## Changed (Mar 14, 2004)

I'm curious about this too. The LC's i've seen in the past always insist tht I try a nipple shield. That of course skrews everything up and the babies never want to wean off the sheilds. I have slightly flat nips but no bad. This time I'm not going to fall into the breast sheild trap. I *think* the 6 months of pumpng with my last baby may have corrected the problem. It seems to me that they stick out a little more than they did before. I do have some shells that I used with DD. I hated than ALOT.... talk about headlights! Anyway, I think i'm armed with EVERYTHING I could possibly need just in case. Shells,a PIS pump, an isis hand pump, good nursing bras........ WHat else could I need?


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## CarrieMF (Mar 7, 2004)

The shells are better than the shields.

I have 1 flatish nipple. It's not completely flat but I have to sandwich the breast to make it longer so they could latch on properly.

A true flat nipple is one that does not become erect when stimulated or cold

Pumping for a couple of minutes right before breastfeeding may help bring the nipple out.


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## veganmamma (Sep 10, 2002)

CarrieMF, that is not my understanding at all. My SIL just dealt with flat nipples and latching on a newborn and she had a breastfeeding counselor at her house almost every day. One of the first thigns she learned was that her nipples were inverted despite the fact that they became erect when cold. I'm wondering where you heard that "true" flat nipples never become erect. It seems to me a nipple is truly flat or truly inverted when the baby tries to latch on and instead of extending back towards the throat it pinches and goes inside. Obviously there are posters here who had flat nipples and were able to achieve nipple erection.


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## dharmama (Dec 29, 2002)

Hi, my name is Erin and I have inverted nipples! :LOL

I swear I have told more people about my nipples in the last two weeks than I could have ever imagined!









Re: Nipple shields

Quote:

That of course skrews everything up and the babies never want to wean off the sheilds.
A lot of people have started with shields and successfully weaned off them. I am close to doing it myself and my dd is only 2 1/2 weeks old! We're off the shield on one side and if I start her on the shield on the other side, I can slip it off and the nipple is erect enough to latch her on!







I recently posted a thread about this. Lemme find it and I'll post a link.

I'm also wearing shells, which go in your bra in between feedings. These help to draw the nips out. (They are MESSY though....I leak like crazy when I'm wearing them.







)

To the OP...I would encourage her to go for it. Nursing w/ inverted nipples can be done!! It was VERY hard in the beginning (and still is at times). I've had a LOT of support from LLL and the hospital LC but we're doing it!!!









~Erin









ETA link: My inverted nipple thread


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## wombat (Nov 3, 2002)

So what's the difference between inverted and flat nipples? Is it just the degree of inversion? So that flat nipples are just a less severe form of inverted nipples?


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## dharmama (Dec 29, 2002)

Quote:

So what's the difference between inverted and flat nipples? Is it just the degree of inversion? So that flat nipples are just a less severe form of inverted nipples?
I think that's it. When my nipples were inverted there was a slit where the nipple would be and the nipple was tucked inside. As they started to come out they were flat...I could see the whole nipple (no slit) but they were totally flat and even with the rest of my breast.

At this point my right nipple is flat "at rest" but becomes fully errect from the slightest latch or from wearing the shells in between nursing.

My left nipple is still inverted "at rest", becomes flat or _slightly_ errect when I wear the shell and after a couple of minutes of nursing with the shield it comes out and she can latch w/ out the shield if I slide it off.

Soooo....I think my nipples experience all stages -- inversion, flatness and whatever "regular" nips are called :LOL

Doh...crying baby...time to put the nips to work...


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## applejuice (Oct 8, 2002)

I suggest that you try to keep the breast from getting too full, and use an ice cube to pull those nippers out and up! Using a shield or shell is good also...maybe put it in the freezer first?


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## 3 little birds (Nov 19, 2001)

I didn't really realize that I had flat nipples until my twins were born. They could not latch on.

After I started begging for a lactation consultant at the hospital, I was given the shells to put in my bra. Soon I was leaking colustrum all over the place. I was so happy.

I also used my Avent breastpump before nursing to pull the nipples out and help break the adhesions.

Sandwiching the whole areola area for the babies helped alot also.

It took about a week, but we were able to get the girls latched on and off the formula. It did hurt but it was totally worth it.

Now the headlights are ALWAYS on high!


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## CarrieMF (Mar 7, 2004)

Quote:

One of the first thigns she learned was that her nipples were inverted despite the fact that they became erect when cold. I'm wondering where you heard that "true" flat nipples never become erect.
I read it in The Breastfeeding Answer book from LLL. There is a difference between inverted & flat. Inverted nipples have adhesions and that is what causes them to turn in, flat nipples do not turn in at all.


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## Gidget (Aug 31, 2002)

This flat vs. inverted talk reminded of something I have forgotten about. My nipples were inverted before I had ds1. After he weaned ,they did not reinvert, but they flattened out. They stayed that way till dd and they were normal the whole time I nursed. After she weaned, they slowly became flat again, then they were "normal" again after ds2 was born and nursed. I imagine after he weans they will probably flatten again. I think I may have already said this, but it never caused us issues since my areola are pointy too and I have been able to stimulate the nipple to stand out for baby to grasp. Has anyone else here had the whole flattening after weaning?


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## veganmamma (Sep 10, 2002)

Quote:


Originally Posted by *CarrieMF*
I read it in The Breastfeeding Answer book from LLL. There is a difference between inverted & flat. Inverted nipples have adhesions and that is what causes them to turn in, flat nipples do not turn in at all.

I agree there is a difference between flat and inverted, but both can become erect. I hope that is corrected in the newest edition of the Answer Book.


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## LaffNowCryLater (May 2, 2003)

I had one flat nipple (my left side) and my dd had latch problems, she could pull it out but not suck on it correctly. Hard to explain. It hurt so bad I stopped nursing and only pumping just so it could get a chance to heal and then I put her back on it. It cracked again, but I just let her continue nursing and figured I would be in pain for at least 12 months b/c there was no way I was gonna stop nursing. I was planning on getting help, but had no time to do it right then. Then one day, when she was 6 weeks, she just magically latched on correctly and we have been smooth sailing since.
I am probably not much help.

ETA: In the hospital, right after giving birth I couldn't get it to come out at all, but I had brought my pump and that helped a lot. Then it would come out, but then I had the latch problem to still work on.


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## veganmamma (Sep 10, 2002)

:LOL That's about the same as me, one day, she just got it. Well, I'll have to talk to my client to see if it's inverted or flat or what, but I really appreciate the input.


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## CarrieMF (Mar 7, 2004)

Quote:

I hope that is corrected in the newest edition of the Answer Book.
It is the newest edition.


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## monkaha (Jan 22, 2004)

I had flat/inverted nipples (I think inverted, but honestly can't remember which now) when DD was born. I had so much trouble trying to get her to nurse the first couple days that the ped that saw her in the hosp ordered me to give her some formula! That, of course made me more determined than ever to nurse, and the LC at the hosp was WONDERFUL! She had me pump, gave me shells (yeah, they are MESSY!) and when nothing else worked, gave me the shields. The sheilds made it possible for DD to nurse. They didn't affect my supply at all (could have fed the whole neighborhood! LOL) and she did eventually wean from them. It took about 3 months for her to be able to nurse without them. Good luck to your client, she's lucky to have you to help her!


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## jilson41 (Jul 25, 2003)

Just to add my experience...
I had flat nipples. Before I was pregnant, they were flush with the areola except when erect--they stood out maybe 1/4 inch at the most. During pregnancy, they stuck out a little more, but I still would call them flat.
After birth the LC helped me by:
hand pumping before BF
using shells between feeds
using a shield during feeds
The shield was especially helpful in getting DD to latch on b/c she like to suck on her tongue and so it was often in the way. The shield provided a big nipple to stick in her mouth and hold her tongue down.
I stopped using hte hand pump after the first day. We weaned from the shield in the first week. I used the shells for 1 1/2 weeks--mainly to keep my tender nipples from rubbing against clothing.
All in all, I didn't find my flat nipples to be much of a problem. It was just a part of learning to BF. They are no longer flat, but certainly not as big as other mamas'. The LC reminded me that DD nurses from the areola, not on the nipple only, so inverted or flat nipples shouldn't be too much of an obstacle.
Good luck to your client!
Jill


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## Quirky (Jun 18, 2002)

What about the Niplette (yeah, I know







) by Avent? To help break the adhesions before baby is born...

http://www.motheringfromtheheart.com/nipletteinfo.htm


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## USAmma (Nov 29, 2001)

If anyone wants to see a photo of an inverted nipple, I took a photo of mine to share for educational purposes.









http://www.home.earthlink.net/~sukum...atnipples.html

I was unsuccessful in nursing my first despite lots of support and professional help. I chose not to nurse my second because of the emotional/physical pain in trying to nurse my first. I pumped for both for a total of 6.5 months through a total of 7 cases of mastitus and one case of thrush. Even in the periods with no infections it was very painful to pump, moreso in the times I tried to nurse. My baby has a feeding aversion so I don't think she would nurse even if I had chosen to. She eats by NG tube for the most part.









I think if she can grit her teeth and come prepared to do whatever it takes to nurse, and her baby is normal and healthy, she should be able to do it. One thing I toyed around with but never did was to have my best friend nurse my baby to teach her how to latch on correctly, and have her older baby nurse on me to draw out my flat nipples. But dh had a problem with that idea so that was that.

Darshani


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## Changed (Mar 14, 2004)

That avent thing looks neat. I'm getting too far along to use it now though NTM the 52.00 price tag. I have some shells and i'll use them if I need to. I was thinking it would be just as good to use a hand pump on one side to pul it out a little before a feeding for a while *if* there seems to be big trouble using nothing. I have an isis hand pump and a pump in style. I'm taking the isis to the hospital and a good nursing pillow.


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## MommytoTwo (Jun 20, 2004)

So- if you have flat nipples but they do stand out when cold, can you put an ice cube on them for just a quick second before putting baby on? I have flat nipples and had a tought time with DS. I pumped and used shells. I hated the shells though.


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## simonee (Nov 21, 2001)

Mine are inverted, but one has come out with bf'ing and the other one, like Lauren's, fell into disgrace. Not just the nip, but I think the inner adhesions (which despite nursing never came loose) somehow make the flow bad. The milk never squirted out like a shower, but kinda in all directions due to the weird positioning of duct outlets all over the nipple, and some of the sprays were watery and others had very thick milk that didn't taste sweet at all. So both babies started to refuse that breast at 1 or 2 months old. The other one functions quite normal and textbook though.


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## veganmamma (Sep 10, 2002)

Simonee-- I love your sig line!!

Thanks for all the ideas. I'm hoping to have a LLL leader come visit her in the hospital or something because I am not crazy about hospital working IBCLCs, yk? I think a LLL breastfeeding counselor would be better.


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## kimberlylibby (Dec 28, 2003)

Can I hop in here?

I have nips so inverted they are ridiculous.

My cure? PUMPING. I ended up pumping the first 10 weeks of dd's life and slowly but painfully-surely those adhesions ripped and my nipples are now probably fairly normalish.

At 10 weeks old, dd finally latched on to my newly-erect nipples.

I'm 36 weeks pg now, and I can tell that my adhesions have reformed or whatever to an extent, but they're not nearly as bad as they were before....

Getting nursing established was pure torture.... she would scream at the breast, even when I had milk POURING out....

I met with a dozen LC's and honestly, none of them were very helpful.... I think it was just a time issue for us... time to rip my nipples into shape and time for dd's oral skills to improve.

Kimberly


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## DaryLLL (Aug 12, 2002)

Quote:


Originally Posted by *kimberlylibby*
I met with a dozen LC's and honestly, none of them were very helpful
Kimberly

Really?! A dozen? That has got to be a record. All IBCLCs?


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## kimberlylibby (Dec 28, 2003)

Yeah, Daryl, I was a pro at the lc route.

I saw 2 at the hospital, 5 locally, 3 at the breast center at a hospital in fort worth (that's 10 so far), 2 via the phone (not local), (that's 12).

Crazy, eh? I do think the one who rented me the Medela scale was helpful though.









At least half were IBCLCs. I don't think the hospital ones were... they were pretty unhelpful anyway. "I can't find your nipple, but if you want some formula...." uke
Kimberly


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## Changed (Mar 14, 2004)

I met with all of the LC at Harris in Ft Worth. They were pretty good as far as directing a preemie nursing mother. They did push the nipple shield and I didn;t want to use it AT ALL. BUT, OTOH they encouraged me to nurse and pump as long as I could and were very supportive when there were problems coming all the way to the NICU with me to help.


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## Viola (Feb 1, 2002)

I'm finding this thread interesting. I thought I had flat nipples before I had my first baby since my nipples were rarely ever erect, and it barely looked like I had any. I read somewhere (Nursing Mother's Companion, maybe?) that you can do a test to see if they are truly inverted because they might look flat but be OK. If you pinch the area just behind the nipple and it goes in, they are inverted, but if they go out, then they are not. Mine seemed to go out when I did this, not much, but at least they didn't go in so I didn't worry about it. I did have a lot of pain breastfeeding at first. Now they spring right out when I do this, and they are generally much bigger and "formed" so I guess the nursing has changed them. So now I'm thinking maybe I did have flat nipples and there were things I might have done to make the latching on go better.


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## Changed (Mar 14, 2004)

I know this thread is pretty old but I found it again searching for answers.

Well, update, I had my baby. And, I'm back on nipple sheilds. Some days he hardly uses it at all and some almost all day. Most of the time he uses it for all night feedings. I'm pretty bummed about needing it. It feels like im only sort of breastfeeding. I do always try without it and sometimes that goes so smoothly and other times he flips out and gets so frustrated. Nursing doesn't hurt too bad considering I have flat nipples. I have been to a LC twice and the first time she have me a sheild and flipped about his weight loss at 2 days old and the second LC said he nursed great without it and took 2 ounces at 6 days old in just 6 minutes. I have seriously overactive letdown so that accounts for his intake being so quick I guess. Anyway, I just need to know that A) we CAN wean off the sheild and B) how the heck to actually accomplish that goal. They always say you can wean off it but no one seems to know HOW. I need a clear goal. I need a plan and I need to know that other moms have done this and continued onto a great and long BF relationship. This is SO important to me on so many levels. Oh, and all the local LLL people I've talked to were pretty clueless. Wonderful women but no help to me. Good news is that the LC here are all free and I can go see them as often as I need to. Advice? Success? Thanks!!!!


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## monkaha (Jan 22, 2004)

First, congrats!! on the babe!

Second, (((HUGS))) you are really truelly breastfeeding! Not just sort of, REALLY! (though I know the feeling, that's how I felt using it too)

I was able to wean DD off the shield by about 12 weeks, though most people I've heard from take much less time than that. Since he goes some days without it, I'd guess it won't take you as long.

What worked for us was wearing shells, and starting feeds with the shield and taking it off at some time during the feed. Then having less and less time with the shield on before removing it. I also pumped a lot; I was paranoid about supply (though it wasn't really a prob) but I think it may have helped to loosen the adhesions or whatever was making them flat.

I think I saw some info at kellymom.com too.

good luck!


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## karlin (Apr 8, 2004)

I had flat nipples as well. My DS was in the NICU for 6 days ("for observation"), and my milk did not come in well until day 6 (probably not a coincidence). I pumped and used shields (I honestly thought that he couldn't get enough milk through the shield even though I had a huge supply and overactive letdown because of stuff I had read). I pumped for nearly a month and bottlefed, but I tried to put him to my breast everyday (though not as much as I should have looking back). He was born 6 weeks early on 9/6, and finally took the breast without a shield 10/1. It sometimes took 20 minutes of trying to get him to latch on every time he nursed for the next week, but I never switched back to the shield or the bottle. He had a few nursing strikes many months later where I gave him a few bottles of EBM, but he was old enough where it didn't confuse him. The first day I got DS to latch, I had DH watch him while I took a nap...and I told him he NEEDED to wake me up when DS got hungry, but DH gave him a bottle of EBM! I was so pissed....I thought all my work was for naught....but DS latched again after that....and every time we nursed since (he's 15 months and still going strong). He hasn't had formula since the day after we left the hospital.

I really think pumping helped my nipples come out a little, and the fact that DS got bigger and better at sucking. I always had to make a "nipple sandwich" for him to latch on to for awhile, but boy was all the work worth it. Stick with it mama, you're doing a great job!!


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## DaryLLL (Aug 12, 2002)

mhl, congratulations. You are breastfeeding. Sometimes nature needs just a little help. We are not textbook cases, but real people with specific issues. Every problem has its solution.

If he can already nurse sometimes without a shield, that is great! I am sure it is frustrating when he will sometimes and won't other times. Like, "Hey, you did it yesterday, baby, why not now?" But we all have our moods, even babies, right?

He is only 2 weeks old. Give him time. Often it takes weeks to iron out all the wrinkles. Take good care of yourself. Eat well, drink tons and take naps.


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## Changed (Mar 14, 2004)

DaryLLL, I'm so glad you responded. You are a wealth of knowledge and I truly appreciate the help from all of you. Nighttime seems to be our downfall. Between us both being tired and trying not to wake everyone else and have to get up and turn all the lights on the sheild is just SO easy. I ought to just trash is and force us both to get through this. I'm so amazed that I have no trauma to my niples. He's off and on so many times and is feeding a few mintues at a time hourly. Sometimes he goes longer but he's usually full in about 6 minutes. Then again an hour later. Is that OK? Should I give him a paci or make him wait a full 2 hours? He does sleep a full 2 hours at night between feeding and sometimes a little longer. THANKS!


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## DaryLLL (Aug 12, 2002)

Quote:


Originally Posted by *my~hearts~light*
DaryLLL, I'm so glad you responded. You are a wealth of knowledge and I truly appreciate the help from all of you.

Thanks!









Quote:

Nighttime seems to be our downfall. Between us both being tired and trying not to wake everyone else and have to get up and turn all the lights on the sheild is just SO easy. I ought to just trash is and force us both to get through this. I'm so amazed that I have no trauma to my niples. He's off and
Ah, take it easy on yourself. You need your sleep and so does he.

Quote:

on so many times and is feeding a few mintues at a time hourly. Sometimes he goes longer but he's usually full in about 6 minutes. Then again an hour later. Is that OK? Should I give him a paci or make him wait a full 2 hours? He does sleep a full 2 hours at night between feeding and sometimes a little longer. THANKS!
NO! No paci, no waiting! Short frequent feeds are just what you need. Esp if you have overactive letdowns/oversupply. You are doing fine. The more feeds, the more practice he gets at latching too.


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## Changed (Mar 14, 2004)

Ok thanks~I know it's silly but I so badly want to have things going well by Christmas. We'll be traveling and my sister who is pregnant with her first is coming to visit. I want to show her how wonderful it can be and how important BF is for the baby. I jsut worry that I will ruin her on it for her own baby if things are still so rocky.


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## chanale (May 6, 2004)

MHL - Congrats on your little boy! Please don't worry about your sister. If anything, I think you have even more to be proud of than your average BF mom because you have stuck with it despite difficulties - that really sends a message of how important it is.

I'm feeding my 8-week-old with inverted nipples. I don't know it feels like to nurse without discomfort or pain. I saw an IBCLC every day for 2 weeks and continue to see her periodically. My daughter didn't even try to latch on until she was 4 days old, and when she finally did, I was bleeding and bruised. She nurses with a shield 90% of the time so there's something to latch on to. Anyway, I just wanted to say that I found it encouraging to hear that other babies have weaned off the shield at older ages - it gives me hope that my daughter will do so eventually, too.


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## Changed (Mar 14, 2004)

Oh waht a night! I'm getting so frustrated I could scream. My 5 year old is making me insane and acting out in every way possible and I'm too busy and flusterday to deal with her. Cole is flipping out and showing real confusion at the breast. He seems to hate being held at all while nursing. Positioning to nurse has to be me chasing his mouth with my nipple because if I even try to position his head he flips. I can't even hold him by his neck like you would for clutch hold. I'm not sure why it bothers him so bad all the sudden. He nurses best lying down without me touching him but has to have the sheild in that position. What on earth am I going to do? I am NOT looking forward to another night fighting with him.


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## DaryLLL (Aug 12, 2002)

You say you have serious overactive letdown.

That might be why he prefers nursing lying down. he can control the flow better that way.

Another position you can try is reclining (in reclining chair or couch) with him on top of you so milk has to go uphill, against gravity.

I assume you are doing one breast only per feeding right? You might want to go one breast only for a 3 hr period, even if there are 3 feeds in that time.


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## dharmama (Dec 29, 2002)

I know it's hard mama but keep up the great work!!









I have inverted nipples and we used a shield for 9 weeks until dd's suck was strong enough and her mouth big enough that she can latch on to my breast and draw the nipple out and into her mouth. (My nipples still invert in between feedings.)

Try not to set a time limit for yourself...just offer the unshielded breast a couple of times each day and see what happens.

For a long time my dd was able to nurse w/out the shield ONLY if we were at home alone and I was very relaxed. So during that time I used the shield (which I carried right in my bra to be more discrete putting it on) in public and at night.

You'll get there mama!!!!


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## Changed (Mar 14, 2004)

i think i figured it out. 10 day growth spurt? nursed and fussed at hte breast ALL NIGHT.


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## mezzaluna (Jun 8, 2004)

if i can join in here - because i'm having some similar problems...

my little one is 5 days old now, and latching has not been easy for us. i have flattish nipples... and i'm willing to endure a few seconds of pain at the beginning of each feed, but the real problem is how long it takes us to get latched on in the first place. he gets really frustrated, fusses, swings his head back and forth and flails his arms. i swaddle him a lot of the time before feeding, which helps with the arms and seems to calm him down a little more for nursing.

i went to an LC yesterday and we got things working pretty well there - one hand guiding his head down low, one hand supporting my breast, but far back from the nipple so my fingers don't bump his head and make him turn and root elsewhere. but back at home things aren't always so great - i have a hard time guiding his large head (he was 8lb14oz at birth) when he'd rather be swinging it side to side.

my nipples are so sore i have to muster up the courage to nurse... they bleed occasionally. i have been putting on lansinoh a couple times a day, and i always rub in some BM and let them air dry afterwards. i feed the less sore side first, since his latch is better after he's fed some and is more at ease.

oh, he also seems to like being more on top of my breast, but i can't always get him in a good position for that. and side-lying worked for us in the hospital, but not since we got home. my milk came in on day 2, and there seems to be plenty and he's getting plenty... nearly regained his birthweight already, and has plenty of wet&poopy diapers. it's possible he's getting too much let-down at first, but i'm not sure how i would tell... my main problem is that he's fussy before we even get to the latch.

appreciate any advice - if this isn't related to flat nipples i can start a new thread









thanks!


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## Changed (Mar 14, 2004)

you have my baby and boob problems!!!!!!!!! no ideas, we'll get through this! I hate that head shaking rooting furious thing don't you?


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## mezzaluna (Jun 8, 2004)

yeah - i especially hate to see how he only opens wide as he turns his head to the side...

well, the first three tries at sidelying worked tonight! but try 4 didn't, i started bleeding (i hate seeing bloody spitup







) but we eventually latched on in a reclining position with him coming down more on top of my breast. he doesn't fuss as much at sidelying, but he has trouble opening wide...well and tonight he kept falling asleep in the middle of latching on. since i've just fed him on and off for the last 1.5 hours, dh is now trying to soothe him to sleep without another go at the breast. i'd like an hour to recouperate before going at it again... whew...

if he's gentle, his playing at the breast first helps draw out the nipple to make it easier for him to latch, but generally he's grabbing it with his hand or mashing it in his mouth at the first opportunity. (oh yeah, sidelying helps because i can pin one hand under my breast and i have a free hand to hold his other... maybe he'll get the idea to hold on to the sides eventually and not flail!)


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## DaryLLL (Aug 12, 2002)

Try these links:

http://www.breastfeed-essentials.com...ednipples.html

http://www.breastfeeding-basics.com/...inverted.shtml

http://www.medela.com/NewFiles/flatinvnips.html


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## JoyofBirth (Mar 16, 2004)

I have flat nipples. I have to wear a nipple shield. Sometimes now I can my baby to latch without it but she pulls off and on a lot w/o it. It did hurt quite a bit at first and occasionally hurts now w/o the shield, because she sucks a lot harder to get nipple out. I don't mind the shield because I know she's getting a good latch. I'm a student mw and we had a client with a baby who had failure to thrive because she would not use the shield and the baby was only getting foremilk, so this is something to watch for, too. The baby must have the right latch to get hind milk. HTH


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## dharmama (Dec 29, 2002)

mezzaluna and my~hearts~light....

Thinking of you!!







How's it going?

Are you guys both wearing breast shells (not shields) in between nursings? That made a HUGE difference for me. It keeps your clothing off your nipples and allows the air to get in...plus the pressure on the areola helps to pull the nipples out more.

The only problem I had with the shells is that I leaked a LOT when I wore them!







I had to cut up washcloths and tuck them inside the shells to absorb the milk AND I had to wear breast pads over the shells just in case.

But when I pulled the shells off, my nipples would be more out than without and my dd could often latch without the shields.


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## Changed (Mar 14, 2004)

IT's going much better for us now. We still use the sheild a few times at night but other than that not at all. truthfully, I could do away with it but it would mean a few LONG hard nights of waking all the way up and taking him out of bed to get positioned well to feed him and i'm just lazy for that.

We took him to his 2 week checkup today. Actually, he was 2 weeks tuesday so 2 weeks plus. Anyway, he was doing great!!

His weight is up to 7.2 from a low of 5.12~~~!!!!!!!In 2 weeks he gained over a pound! I was so worried about his weight before it was a real relief on my mind. Everything else was great. We had to do te second PKU today. I feel horribly about that, poor guy. Anyway, Things are SO much better.

I'm seeing why so many mamas here love nursing their babies. It's so special and amazing when you get past the hardest part.


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## DaryLLL (Aug 12, 2002)

Oh, MHL, that is great news~!


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## mezzaluna (Jun 8, 2004)

things are better but not great. my left nipple has mostly healed from the earlier difficulties and it pretty much only hurts at latch-on. my right nipple still looks unhappy, though better than it was. it hurts *a lot* at latch on, but only slightly during. the main problem is just that i'm so scared to let him latch on the right. if he's fussing, head-butting, grabbing at my nipple it just hurts too much and i have to take a break (and usually cry







)

i'm wearing a soothies gel pad on the right side,, and it seems to be healing, but very slowly. i was thinking about pumping a bit first to draw the nipple out and make it easier for him to latch with less fussing and pain... would this help?

also, how could it be affecting my supply if nursing is more erratic on the right? i can only face so many latchons per day on that side. sometimes its a long feed, sometimes short...


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## DaryLLL (Aug 12, 2002)

Quote:


Originally Posted by *mezzaluna*
things are better but not great. my left nipple has mostly healed from the earlier difficulties and it pretty much only hurts at latch-on. my right nipple still looks unhappy, though better than it was. it hurts *a lot* at latch on, but only slightly during. the main problem is just that i'm so scared to let him latch on the right. if he's fussing, head-butting, grabbing at my nipple it just hurts too much and i have to take a break (and usually cry

Try to feed frequently. I know, you dread nursing, but if you don't let him get ravenous, he won't be as frantic at the breast. Don't use pacifiers. This might confuse him and hold him off from nursing when he is just a little hungry.

Quote:

i'm wearing a soothies gel pad on the right side,, and it seems to be healing, but very slowly. i was thinking about pumping a bit first to draw the nipple out and make it easier for him to latch with less fussing and pain... would this help?
Yes, lots of moms do that. Did you read the links I posted a few posts back?

Quote:

also, how could it be affecting my supply if nursing is more erratic on the right? i can only face so many latchons per day on that side. sometimes its a long feed, sometimes short.
Well, lots of babies nurse for longer and shorter times throughout the day. Sometimes they just want a drink or a snack, sometimes a full course meal. If your hurting breast is getting less stimulation overall, its supply will be less than the good side, but then the good side will make up the difference.
It all works out.

if you get overfull on the hurting side b/c baby will not latch well, you can and should pump to comfort and maybe give him that milk in a dropper or spoon.

Keep up the good work! :bf


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## monkaha (Jan 22, 2004)

Quote:


Originally Posted by *mezzaluna*
i was thinking about pumping a bit first to draw the nipple out and make it easier for him to latch with less fussing and pain... would this help?

also, how could it be affecting my supply if nursing is more erratic on the right? i can only face so many latchons per day on that side. sometimes its a long feed, sometimes short...

That's what I did-pumped first and then latch on. Also, like DaryLLL said, you can just pump that side and feed it later. I had a few days like that with DS, where I only nursed on one side and only pumped the other. It really helped me heal. Aren't those soothies pads great! You can cut them in half to make them last longer. (wait, those are the disposable ones, right? disregard that if you have reusable ones







)


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## mezzaluna (Jun 8, 2004)

thanks DaryLLL and Monica! it's nice to have your reassurance









DaryLLL, i did read those links back when you posted them - maybe that's where i got the idea. i will giving pumping to draw out the nipple a try, and if that's not helping i'll trying pumping and giving the right breast a break for a while. i do usually try to feed the left side first so he's not so frantic by the time he gets to the right side.

Monica, I have the disposable ones... I'm just using one on the right breast... will use the 2nd one on it next. i find they slide around a lot in my bra, so i don't think i could cut them in half and use them effectively.

i've also decided to go see an LC again tomorrow, even though the clinic is open right at the time when my family arrives from way out of town for the holidays. i found out recently my mom was an LLL leader in the 70s, so i think she'll understand


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## Changed (Mar 14, 2004)

to cool!!! maybe your mom can help too. i'm still having a hard time getting him to latch at night without the sheild on the right side. I think i'll take a hand pump to bed tonight and see if that helps. I have a PIS but it's a pain to get up and pump with that. Besides, maybe the avent will rip the adhesions faster since I control the suction. I want some soothies. BOY they are expensive at walgreens a set is 14 bucks. Are they reusable?


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## mezzaluna (Jun 8, 2004)

i had great success with a hand pump this evening!! after pumping a little bit my nipple was drawn out well and he was much more able to latch and the pain was greatly reduced, whew. it's sitting next to the bed for middle of the night feedings...we'll see how that goes. i assume if i'm not actually using it to collect milk that i don't need to be fastidious about sterilizing it? i sterilized it before first use, but thought i'd go with just washing it out with hot water between uses now.

the soothies say to use for 3 days, and you can wipe them up to clean them a little during that time. dh picked them up at CVS for me - he says he thinks they were $12 there. since i'm just using it on one side, that will last me 6 days. i've also used ice packs after nursing, and have used ibuprofen on and off, especially at night, since we have the hardest time latching then.

MHL good luck with the hand pump tonight!

my pump just came in the mail today... dh is acquainted with this guy who's an inventor in britain, and it turns out he invented a single-handed breast pump... so he sent us one as a gift. seems to work fine - it's a tommee tippee freedom breast pump.


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## aja-belly (Oct 7, 2004)

why is the niplette so expenive? it's like a small peice of tubing and a syringe. argh!

any other brands of similar things, or anyone have a good recipe for a home made one?

i'm gonna post on the trading post to see if anyone has one they'd be willing to sell.

aja


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## Changed (Mar 14, 2004)

I wanted to get one for my sister but wow are they pricey. Since flat nips runs in the family I wanted to help her head off trouble but....


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