Carole:

   for some women shells work well and this is a excellent proactive method
of preparation.

   what the study shows is that for some women this method does not work and
may well be off puting. it is one study with a limited no. of participants,

 .. there is a ring of muscles that "erect" the nipple. some inverted nipples
are inverted due to adhesions preventing the muscles from erecting the nipple
and so when a shell or hoffman exercies, or a baby's nursing exerts pressure
than the adhesions break down and the nipple erects... if the musclature is
not there, no exercise or pressure will erect the nipple.

   understanding that a nipple is not essential for bf/ other than as the
container of the ducltal endings... the babymust be well latched onto the
breast.

    talk to the mom, giver her the options and let her choose the method she
is most comfortable with.

   Patricia

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