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correspondence

Indian Pediatr 2011;48: 245

A Novel Approach to Correct Retracted Nipples


Sunil Rathi and Jagdish Mandliya

RD Gardi Medical College, Ujjain, MP, India.
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Retracted nipples is a very common problem with a reported prevalence of 9.8% in pregnant mothers [1]. It is also a very important cause of lactation failure due to inability of baby to suckle at breast. Usual methods to treat retracted nipples include manual eversion of nipples by fingers (Hoffman technique), using syringe pump, and breast shield [2]. Breast shield is no more recommended because of fear of creating nipple confusion and infection. Use of manual eversion and syringe pump singly or in combination are mostly successful in treating retracted nipples. A few more non surgical methods like suction pump fitted bra and breast jewellery to maintain protectility of the nipples have been described. In resistant cases, surgical correction can be done but it is possible only before pregnancy.

Recently, in a primiparous mother, who presented to us with grade 2 retracted nipples (Han and Hong classification) [3], these methods failed to correct the condition. Baby was given expressed breastmilk by spoon. However, the parents were very keen to establish breastfeeding. As the conventional methods to correct the retracted nipples had failed, we requested the father to suck at nipples of his wife frequently to correct the retracted nipples. The first concern of the father was that while sucking at breast, milk will go in his mouth. We reassured him that this human milk will not cause any untoward effects even if swallowed. Father agreed and over next one week the problem had improved.

When other conventional methods fails to correct retracted nipples, often due to insufficient mechanical suction, husband can be used as a good suction machine. The natural relations between husband and wife should overcome any inhibitions for some thing which will go a long way for their baby. Vigorous sucking by husband will not only help in correcting retracted nipples but will also improve lactation by stimulation of prolactin and oxytocin reflexes.

References

1. Alexander J, Campbell M. Prevalence of inverted and non-protractile nipples in antenatal women who intend to breastfeed. Breast. 1997;6:72-8.

2. Singh M. Care of the Newborn, 6th ed. New Delhi: Sagar Publication. 2004;170.

3. Han S, Hong YG. The inverted nipple: its grading and surgical correction. Plast Reconstr Surg. 1999;104:389-95.
 

 

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