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From:
pat Bull <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 28 Nov 1995 17:22:30 -0500
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Sarah Barnett,

Nothing needs to be done prenatally, except to be seen by an LC to be
educated as to expectations after the baby is born.  Also, the person should
go through a BFC. for education.  A study was done by Alexander, Grant,
Campbell, "Randomised controlled trial of breast shells and Hoffman's
exercises fro inverted and non-protractile nipples", BMJ, 1992 and showed
shells and exercises are not effective for inverted/nonprotractile nipples.
 Unfortunately, we use to suggest to begin wearing the shells the last
trimester.  What are we telling these moms?  They have a problem and they
need to wear these devices to make things work.  What I have found very
effective and why now Medela in their instructions for flat/inverted nipples
will read " Begin wearing the shells a few weeks prior to delivery date.  We
do not believe the adhesions are broken down by the exercises and shells.  We
do know that with wearing the shells, the nipple is drawn out.  The idea is
to begin wearing the shells prenatally and take them to the hospital.   After
the baby is born, if they have difficulty with latch-on, they can continue to
wear the shells until good latch on.  (How many hospitlals do not have shells
and it is more expensive for the mother to get them in the hospital)  I have
spoken to several LC's and they all agree that the shells are beneficial for
flat/inverted nipples in the hospital and going home.

Pat Bull, RN, IBCLC
The Breastfeeding Connection
754 Raintree Dr.
Naperville, IL  60540
(708) 420-2172

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