title: Management of flat or inverted nipples with simple rubber bands.
abstract: BACKGROUND
  Occurrences of flat or inverted nipples are not uncommon problems, and although they should not preclude breastfeeding, they often seriously hamper initiation and continuation of breastfeeding. Various therapies including nipple exercise, breast shells, inverted syringes, or surgical corrections have been reported with varying success rates.
  
  
  METHODS
  A new method has been devised by the authors that consisted of tying a rubber band around the base of the nipple, with the help of a syringe applicator, to make it prominent. Latex rubber bands cut from condom rims were used in this study. The band had to be worn only during feeding. This method was tested on 19 mothers with flat, inverted, or otherwise deformed nipples. The babies were born in hospitals and were between 9 and 38 days old, mostly fed by bottle feeding, at the time of presentation. The mothers had been counseled about the importance of good attachment during breastfeeding and shown the new method. They were instructed to use the method at home and attend follow-up on day 3, day 7, and day 28.
  
  
  RESULTS
  Sixty-three percent of mothers could achieve latching at the breast with good attachment within 3 days, and all did by the end of the month, as nipples no longer remained a problem. The insufficiency of milk was gradually taken care of by frequent suckling with time. No complications like pain or slipping of the band were reported.
  
  
  CONCLUSIONS
  This simple method may be a good bedside solution for flat/retracted nipples. The authors strongly believe that if the new method is applied immediately after birth under supervision, no mother with nipple problem will be required to feed nonhuman milk to her baby.
authors.affiliation: Breastfeeding Promotion Network of India, 286 N.S.C Bose Road, Kolkata, West Bengal, India. drkamalendu@gmail.com
authors.forename: Kamalendu
authors.initials: K
authors.lastname: Chakrabarti
authors.forename: Subhra
authors.initials: S
authors.lastname: Basu
mesh_terms: D001458:Bandages; D001941:Breast Diseases / Q000151:congenital / Q000503:physiopathology / Q000628:therapy*; D001942:Breast Feeding / Q000295:instrumentation / Q000379:methods; D000013:Congenital Abnormalities / Q000628:therapy; D037001:Directive Counseling; D004867:Equipment Design; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009558:Nipples / Q000002:abnormalities / Q000503:physiopathology; D012408:Rubber / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D012408:Rubber