I'm one who thinks breast exams DO matter, but only if you really know what
you're looking for.  I can't TELL you how often the nurses at my hospital tell
me a mother has "flat nipples" when they're perfectly fine.  I always show
pictures and describe how to check for inverted or flat nipples in my prenatal
breastfeeding classes, and offer to do nipple checks after class if a mom thinks
she might have that variety.  Usually one or two women stay after class to be
checked and most are just fine.  On the occasional true inverted nipples I have
seen MAJOR improvement with the use of shells, sometimes only in a matter of
weeks.  The fibrous-wrinkled-flat variety don't seem to improve as easily but
shells do seem to help also.  I read the study from England (I think) years ago
that said that breast shells didn't do anything, but decided to go with what I
had seen with my own eyes rather than somebody else's experience.  Have there
been other studies, using the shells we have available in the U.S.?

Becky Krumwiede, RN, IBCLC, Appleton, WI
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