Help me help a friend... flat nipples

[blizzard_babe]

One of my good friends is due the beginning of May with #2. She had a REALLY hard time BFing #1.

To summarize:

• Baby was a sleepy/lazy nurser
• She has large, flat nipples
• Her hospital's lactation consultant recommended, pretty much from the get-go, that they use a nipple shield
• This made nursing pretty painful; baby would not nurse without it; she was given no help/advice on weaning from the shield
• The LC wasn't helpful past this point, except to criticize her breast pump (it was what she could afford) and recommend she buy a new, better one to better pump milk for the baby.
• at 8wks, it became too painful to endure, so she exclusively pumped and bottle-fed until her son was 6mos, at which point she switched to formula

#2 is well on the way. Her nipples are no less flat than they were last time around, but she desperately wants to make it work. She came to me for advice, and I gave what little I could, and now I'm coming here.

I recommended LLL, and she has contacted them, but is hesitant to pay the $40 join fee (they're not exactly rolling in money) when she's not sure it'll work out. Her only insurance-covered LC is the same woman she had last go-round. So...

I've found her a few helpful (hopefully) articles. But inundate me with information and I shall inundate her. We are women on a mission. Help us.

[groovyem]

My sister and I both have large, flat nipples. She EPed her first and her 2nd there was no problem getting him on. I never got mine on so I'm still pumping at almost 8mo. I wish I would've kept trying. My sister's and my nipples both did "come out" as time went by pumping. My aunt is a part of LLL and her recommendation for me was to pump a little at first to bring the nipple out and then put the baby on. I had some success with this if someone was there to help me (no family close by and hubby works 2nd shift, we were alone alot). It was so frustrating for my little girl and I, but I do really wish we kept going because these nipples sure aren't flat anymore! Have your sister look into renting a pump or finding a used one. I feel for her, good luck and good thoughts your way!

[sahmmie]

Medela makes a product called Nipplette which is designed to draw out flat nipples. It didn't really work for me, but it might for her.

[Mosaic]

That sounds exactly like my situation, but with a very different end result!

1) It shouldn't hurt with the nipple shield. Sure, some discomfort while you're getting the hang of things and drawing the nipple out, but nursing with a shield shouldn't hurt consistently. Maybe it wasn't placed just right, or maybe she needs a slightly different shield, but she definitely needs more support there. You also have to be careful that the baby is nursing correctly on the shield, because in some respects the shield makes it "easier" for the baby, so the baby can develop bad habits. If her nipples didn't draw out before, the shield could still be a useful tool to help pull them out this time, especially if she's still flat after 6 months of pumping!

2) We used the shield exclusively for 6 weeks, didn't even try to ditch it, because DD was a bit early, also very sleepy, lazy nurser, etc. Once we finally started gaining weight, then I'd try ditching the shield here and there: at the beginning of the feed, after switching sides, near the end of the session, etc. I could get her to latch on sometimes, sometimes not, and just kept trying. Eventually I found out that she latched on best without the shield when she was half-asleep... huzzah! I started doing dream feeds, to keep her weight gain and to make more progress losing the shield, and by 8-10 weeks we were shield-free.

3) Get a new LC, one out of network. We paid out-of-pocket for one, and it's totally worth it when you consider the cost of a better pump or formula!! A good LC, who can pinpoint exactly what the problem is and tell you exactly how to fix it, is worth her weight in GOLD. Or PLATINUM. Or inobtainium. Whatever!

Also, just remind her that this is a totally different baby who may be a totally different nurser. Baby 2 may get the hang of it right away, flat nipples and all! You just never know, but I do know that stressing out about it or being worried about it will make it so much harder.

[blizzard_babe]

Thanks, mamas! I've found her a mutual friend who lives close to her who's going to give her some one-on-one help. She also struggles with some... "other" issues. She won't nurse in public, or even in the living room if people are visiting her house (with the exception of close friends and family). Her father gave her a hard time about nursing at his house. Her husband was uncomfortable when *I* nursed in their living room, so it's not like he's super-supportive of her doing whatever, wherever, to get the baby to nurse.

I found a friend who is an experienced breastfeeder (two kids for two years, plus or minus a few months, each), who has experience informally helping new mothers who are starting to nurse, and who is a generally helpful, resource-finding kind of person.

I just wish I could be there to help her, but we won't be in the Lower 48 until a month after the baby is born...

[Quinalla]

This seems like a dumb question, but did she try nursing without the shield with her first? I have one nipple that is flat (though not large) and while it was harder at first and is still not her preferred breast, my daughter was able to latch on and draw the nipple out from the get go. If she did try, then nevermind me, but I figured it was worth asking My baby was a sleepy/lazy nurser too to start and I ended up supplementing for the first few weeks, but all BM all the time after that period

And while I haven't nursed with a shield, I would agree it shouldn't be painful beyond the initial drawing out of the nipple. It's too bad the LC didn't help her more

[blizzard_babe]

I know she tried nursing without the shield at least a few times, but the LC was pretty shield-happy.

[HappyMommy2]

Was baby #1 born via c/s by any chance?

[blizzard_babe]

Originally Posted by HappyMommy2

Was baby #1 born via c/s by any chance?

Nope. Vaginally, with an epidural. Long, difficult labor in a VERY uber-medicalized situation (and I say that as a hospital birther, so, you know...), but a vaginal birth.