I'm sorry,  I just don't get it - what would be the point of assessing flat
nipples before delivery? I have checked a few standard texts and some do
indicate assessment as being of value - but it's unclear how, now we know
that nothing done to flat or inverted nipples antenatally is likely to make
any difference to the bf outcome (MAIN trial).

Having your nipples and breasts assessed and  then 'approved'  does not
mean you will *not* have problems with bf. Nipples and  breasts are no
longer routinely assessed in the UK , I'm happy to say, though they used to
be....someone on Lactnet might know the studies that persuaded UK midwives
to stop doing this, as I recall there were some studies that showed it was
of no benefit. And if an intervention is of no benefit, then of course it
simply should not be done.

In any case, I  think the least likely person to do an assessment would be
an obstetrician...what on earth do they know about bf?? Yikes, I mean
'some' obstetricians, sorry.....I don't mean to be sweeping ; ) . In the
UK,  at least, obstetricians are *not* (ahem)  the first choice of health
professional that one might ask about bf....

Given that women with flat and even truly inverted nipples can bf,  given
skilled help with positioning and attachment if necessary, why make
ante-natal mothers nervous about their ability to bf?  All mothers,
whatever the 'look' of their breasts and nipples in pregnancy, need to get
positioning and attachment right.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK