auuuugh.  Many apologies for the garbled prior post.  I was trying to nurse
a 4 year old and type at the same time.  It didn't work.  Here is a cleaned
up post.

...and for Margery, I would really discourage surgery to correct nipple
inversion.  I cannot imagine any surgery that will not transect any milk
ducts and still release an inverted nipple.
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For those looking for more case histories on the "Niplette"....

This is a device, now commercially available, which is proported to
permanently draw out inverted nipples.  It consists of a cup with a little
tube attached.  There is a one way valve in the tubing and suction is
applied to the nipple through the tube by a detachable 10 cc syringe.  The
original article was by McGeorge in the British Journal of Plastic Surgery
1994; 47:46-9.  He looked at 14 pregnant patients and all went on to
breastfeed "without difficulty".  The complications included two patients
who noted bleeding.

We have been working with a mother who had a moderately retracting dimpled
left nipple and  who wished to breastfeed.  She used the niplette during the
day for three months.  She developed small cracks at the edge of the cup on
two separate occasions.  Each healed after one week of discontinuing the
device. She had a small amount of colostrum present in the niplette each
day.  During the third month, the niplette became more uncomfortable and
from now (month 7) on she will massage the areola several times each day
until her delivery.

I believe that the niplette has cleared the retraction and the nipple
protrudes very nicely with the pinch test.   The nipple remains dimpled in
appearance without the pinch test.  I have taken pictures to show the
progression.  When I get several together, I will write it up.

I also obtained informed consent from the mother before trying the Niplette.
The mother was knew that there was only one study in the literature and I
had had no experience with this product.

Shirley Gross
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M. Shirley Gross M.D.,C.M., C.C.F.P., I.B.C.L.C.
Director, Edmonton Breastfeeding Clinic
Edmonton, Alberta, Canada
E mail at  <  [log in to unmask]  >
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