In a message dated 97-06-11 12:59:18 EDT, you write: > I have just been >asked to do a memo on this for the doctors in the town and would like >to know if anyone still recommeds doing Hoffmans, or using shells? Hello Netters, What I am finding, at least here in US is that most LCs and RNs are no longer teaching the Hoffmans exercises and nipple stretching, but are still recommending the breast shells/Hobbit shells for flat/inverted nipples. Medela, as I was the one that wrote up the info, states to wear the shells a few weeks before due date. I changed that from a few months prior to due date because it was one more thing a mother had to do and felt guilty if she did not start soon enough and length of time wearing them was not that significant. We are not sure if it truly "breaks down adhesions". That is why that was deleted out. What we do know is that after wearing the shells, the nipple is assisted in becoming slightly more protruded. I find that it also helps moms in bringing the shells to the hospital where many hospital still do not carry them. In my clinical experience, I found that, again, the nipple was slightly pulled out after removing the shells, therefore latch-on of baby easier. PS- they do not cause labor with wear. That is another one of those wivestales going around. Any other questions, you are free to e-mail me privately. Pat Bull, RN, IBCLC The Breastfeeding Connection/Medela Naperville, IL