This is a reply to Sharon who asked was there research about Hoffman's nipple
stretching excerises.

The MAIN Trial - Multicentre Randomised Controlled Trial of Alternative
Treatments for Inverted and Non-Protactile Nipples in Pregnancy was done in
1991, I believe, and was designed to find out whether breast shells or nipple
stretching exercises helped, harmed, or made no difference at all to the
number of women with flat or inverted nipples who managed to breastfeed.

463 women in England and in Canada - principal question :  if a woman who
intends to breastfeed and has inverted or flat nipples is advised to use
breast shells or Hoffman's nipple stretching exercises during pregnancy is
she more or less likely to breastfeed for the first 6 weeks after birth?

107 who were asked to use Hoffman's exercises (46%) said they were still
breastfeeding at 6 weeks after birth compared with 100 (44%) of those who had
been asked to not use the exercises.  For women who had been asked to use
breast shells 103 (45%) said they were still breastfeeding at 6 weeks after
their baby was born compared with 104 (45%) of those who were asked not to
use them.

"From what the women who participated  in this trial said it seems that
neither of these treatments is sure to help women to breastfeed.  In fact the
full results showed that it was possible that advising eithere of these
treatments might mean that some women were less likely to breastfeed.  As
there seems no point at all in recommending or using treatments that are not
likely to work, the experiences of the women who joined the MAIN trial
suggest that the Hoffman's exercises and breast shells should not be advised
as antenatal preparation  for breastfeeding.  ....instead should be offered
skilled assistance and postnatal support until breastfeeding is establised."
 Please refer to the  MAIN Trial Collaborative Group.  Preparing for
breastfeeding:  treatment of inverted and non-protractile nipples in
pregnancy.  Midwifery 1994; 10:200-214

If you would like to know more about the results of the MAIN  trial contact
MAIN Trial Office at the National Perinatal Epidemiology  Unit, Radcliffe
Infirmary, Oxford OX2 6HE

I have gone nomail for a time.   Bye for now,   Kathy Bodden.