Lisa,

I remember something about this being said some months ago on Lactnet -
about English breast shells possibly having larger holes on the inside.
According to the papers, the studies in England used shells made by
Eschmann Brothers and Walsh Ltd. The second study was much bigger than the
initial one reported - it is referred to as the MAIN Trial and was written
up in Midwifery Vol 10, pp200-214 (1994). Part of this study was carried
out in Ontario, Canada, so it is not exclusively British.

We used to sell Eschmann shells in NMAA a few years back when I was sales
person for our NMAA Group. If they are indeed the same as the ones we sold,
they have quite a small hole - not like the ones for sore nipples, and they
were designed for inverted nipples. The main difference compared to the
Medela ones, are the Eschmann were all hard plastic (? polycarbonate), ie
both sections, whereas the Medela have a flexible plastic (? silicone)
inner section. However, I do not have the two in front of me to compare
exactly the sizes of the holes. To really check this for sure, perhaps
there is someone out there in Lactnetland who is in Britain, or even in
Canada, who could comment?

I would still tell mums about breast shells, but that no-one really knows
if they really work, etc. and let her decide if she wants to try them. I
have spoken to mothers who reckon they didn't work for them, but so far not
to anyone for whom they did seem to work, so I'm not that convinced.

Joy Anderson IBCLC
Perth, Western Australia
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