Laurie,

I have read about using syringes as nipple everters, but have never used
one for this. I have come across mums using "nipple pullers". I don't know
if you get these in US - they are a P----- product, quite inexpensive, and
look a bit like a miniature old-fashioned glass/rubber bulb type breast
pump. Just before a feed, mum squeezes the bulb, places the glass cone over
the nipple and lets go. Suction draws the nipple out just enough for baby
to attach if mum is quick taking off puller and attaching baby.

The "Niplette" you mentioned is marketed in Australia, and also in Canada I
believe, by C----- A----. It was invented by a British cosmetic surgeon who
was looking for a way to avoid surgery for inverted nipples - ie to correct
for cosmetic reasons. He also found out that correction by this means could
help subsequent breastfeeding. It works by continuous suction on the nipple
(device is worn under the clothes, like all day long and in bed if you
want). This is fine for non-pregnant or non-lactating women, but may not be
appropriate when there is milk or colostrum in the breasts. If milk leaked
out due to the suction, the device would likely fall off. Also some people
have expressed reservations about the small size of the cup which fits over
the nipple and possible infections. In a French study with 6 pregnant
women, they found the mothers reluctant to use the Niplette in the first
trimester because of sensitivity and growth of the breasts. They do not
recommend use during the last trimester because of colostrum secretion.
That only left the 2nd trimester when it could be used during pregnancy.
They go on to suggest that it can be well used in the first few days to
draw out the nipple for the baby (for 5-10 minutes before a feed), before
the milk comes in. I personally see no advantage of this over syringes or
nipple pullers (and these are far cheaper). The original inventor,
McGeorge, reported successfully using it on pregnant women, but did not
specify at which stages of pregnancy they used it. My feeling in general is
that it may be of most use for mothers *before* conception of their next
baby, if they have had problems with inverted nipples with a previous baby
(or get 'em when they are still young women before they get pregnant the
first time! - but as LC's we may not have that opportunity).

I would be interested to hear if anyone has had experience using the
Niplette, and what they thought about it. It can be frustrating trying to
help mums with inverted nipples now that research (those studies done in
Britain) has shown that shells and Hoffman's exercises are not helpful.

Joy Anderson IBCLC
Perth,Western Australia
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P.S. My daughter used to say "deed" when she wanted a feed (she couldn't
say "f")