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.