Nipple aid 'will help thousands of women'

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The Independent Online
HUNDREDS of thousands of women who are unable to breastfeed because they have inverted nipples - a problem estimated to afflict one woman in 10 - could benefit from a simple new device to correct the defect.

A trial involving 17 women reported 100 per cent success after they used the nipple corrector for three months. Two of the women have since given birth and are successfully breastfeeding their children.

The nipple corrector consists of a small, thimble-shaped plastic cup which fits over the nipple area. It can be worn under the clothes.

The thimble is connected by a short piece of tubing to a syringe. When the syringe is drawn out, a tiny valve creates a vacuum in the 'thimble' and suction is exerted on the inverted nipple. The syringe can then be disconnected.

Inverted nipples are usually due to developmental abnormality at puberty, according to Douglas McGeorge, a senior registrar in plastic surgery at Queen Mary's University Hospital, Roehampton, who has developed and tested the device.

The nipple contains tiny openings through which milk can pass. If the milk ducts fail to elongate to compensate for the increase in breast size at puberty, an inverted nipple may result. Instead of protruding, the nipple is turned in on itself.

Mr McGeorge said: 'The thimble-like cup fits over the nipple gently drawing it out (by suction) as far as possible without discomfort. As the tissue expands, the ducts become longer and longer until the nipple actually fills the mould and the muscle inside is strong enough to maintain the stretch.

'This normally takes around a month, after which the woman can begin to wean herself off treatment.'

As well as preventing breastfeeding, inverted nipples could have serious social and psychological implications in teenage and young women, Mr McGeorge said. They grew up thinking that something was wrong with them, and became very self-conscious.

Until now surgery has been a common but unsatisfactory solution, which improves the appearance, but not the function, of the nipple.

'There are hundreds of different operations, which is testament to the fact that none guarantees success,' Mr McGeorge said.

He said that such operations were carried out only for cosmetic reasons and involved cutting the milk-bearing ducts, making breastfeeding impossible.

Previous solutions include the Woolwich Breast Shield - a plastic dome with a hole in the surface which is worn inside the bra. It is designed to expose the nipple by pushing back on the surrounding areola, and was recommended by the National Childbirth Trust until recent trials showed that such devices do not work and in some cases did more harm than good. Some women developed eczema after wearing them.

Another method of drawing the nipple out to its correct position is by using suction. However, customised syringes and tubes connected to vacuum pumps work in the short term only, according to Mr McGeorge. The tissue that forms the milk-bearing ducts is very elastic and will recoil back again with the removal of the force. Only prolonged stretching will elongate the tissue permanently.

Mr McGeorge's device relies on the valve to maintain the suction force for the time it takes to achieve this, and the treatment is painless, he says.

The nipple correctors are small and comfortable enough to be worn beneath loose clothing or in bed, and the longer they are worn the better. The speed of the results also depends on the elasticity of the milk-bearing ducts.

The nipple corrector was recently presented at a meeting of the British Association of Plastic Surgeons and has attracted interest from Europe and America as well as many British hospitals.

The device will be available in pharmacies from April, costing about pounds 10.

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