Therese,

Yes, this topic has been discussed awhile back, look in archives.  The one
study that was done by Royal College of Midwives, Jo M. Alexander, Adrian M.
Grant, Michael J. Campbell and midwives.  "Randomised controlled trial oof
breast shells and Hoffman's exercises for inverted and non-protractile
nipples"  BMJ, 1992:  304: 1030-2.  Objective was to determine the value of
recommending breast shells or Hoffman's exercises, or both to pregnant women
with inverted or non-protractile nipples who intended to BF. There were 96
nulliparous women.  My 2 cents, for what it is worth, is that they used the
older type of breast shells.  Today, some of the shells on the market (for
flat/inverted nipples) have the hole positioned better so pressure is greater
at the base of the nipples to assist bringing the nipple out.  They also
recommended usage of these shells and exercises for a fairly long length of
time, prenatally.  What does that psychologically do to the mother???
 "Something is wrong with me.  I have to wear these shells and do these
exercises every day or I won't be able to BF", etc. etc.  That is why I
changed the info on Medela's tearoff sheets and the instructions on their
shells instructions  to state "ONLY wear the shells a few weeks before due
date" so moms did not have to do all this stuff.  We still do not know (I
believe it does not) if the adhesions at the base of the nipple are broken
down by doing all of this.  I think years ago it sounded good and therefore
we all started to to lecture, write, and tell these things.  Another one of
those wivestales.  I do know that after the women wears the shell and removes
it, her nipple is drawn out more.  Unfortunately, what I have observed in the
hospital when I would make rounds is that if a baby was having difficulty
latching on, a nurse would look at her nipples and breasts and say "maybe
breast shells would help you" when she had perfectly normal erect nipples.
 Again, misusage of BF products!!!!!!!!!!!  The other point that was not
mentioned in this study was the followup and support that these moms got.  It
would make a big difference if these mother's had an LC, LLL, etc. to help
her.  You can not just use products and expect BF to work.  I am off my box.
 Have a good day all.
"Away from the office".  "I think house work is the reason most women go to
the office."
by Mrs. Webster's  Guide to business.

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL