Yan J, Liu L, Zhu Y, Huang G, Wang PP. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health. 2014;14:1267. Men are typically pierced with a 14-gauge needle, and women are typically pierced with a smaller 16-gauge needle. This can vary from person to person, though. Be sure to talk with your piercer about the right size for you. La correzione permanente si ottiene, in genere, dopo l'applicazione continua per un periodo di tempo variabile da 30 a 90 giorni. Come regola Niplette deve essere applicata per almeno 8 ore giornaliere senza interruzione, anche se alcune donne preferiscono applicare Niplette nelle ore notturne.

Grade 2: This grade means it may be more difficult to pull out the nipple than a grade 1 inversion. When released, the nipple retracts inward. Kesaree N, Banapurmath CR, Banapurmath S, Shamanur K. Treatment of inverted nipples using a disposable syringe. J Hum Lact. 1993;9(1):27–9. Both the Hoffman technique and suction cups may be more successful for people with grade 1 or 2 inversion. Surgery can typically remove any grade of inversion. How to determine your grade of nipple inversion

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Nabulsi M, Tamim H, Shamsedine L, Charafeddine L, Yehya N, Kabakian-Khasholian T, et al. A multicomponent intervention to support breastfeeding in Lebanon: A randomized clinical trial. PLoS One. 2019;14(6):e0218467. Nipple piercing is sometimes done to draw out inverted nipples. This is because jewelry worn in the piercing can help keep your nipple in an erect position. You may only experience inversion in one nipple, or even different grades of inversion in each nipple.

Victora CG, Bahl R, Barros AJD, Franҫa GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21 st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90. Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerlć K, et al. SPIRIT 2013 statement: Defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7. During this time, your nipples may turn red or feel achy. In most cases, this happens because the nipple is being forced out. This may also make the actual piercing more painful.Alexander JM, Campbell MJ. Prevalence of inverted and non-protractile nipples in antenatal women who intend to breast-feed. Breast. 1997;6(2):72–8. Chakrabarti K, Basu S. Management of flat or inverted nipples with simple rubber bands. Breastfeed Med. 2011;6(4):215–9. We will randomly allocate eligible women to one of two parallel groups (experimental and control) in a 1:1 ratio according to a computer-generated random sequence. An independent statistician will prepare a set of sequentially numbered opaque sealed envelopes of the allocation group according to the generated random sequence to preserve randomization concealment. A participant’s group allocation will be revealed after verifying that the inclusion/exclusion criteria are met, and after written consent is obtained on the first day postpartum. This will avoid any selection bias introduced by the investigator knowing the allocation of the next subject. Description of the interventions Control group If you’re interested in getting your nipples pierced, do your research. You’ll want to be sure any piercer you choose has a license and experience piercing inverted nipples. Your best bet is to call piercing parlors in your area and let them know what you’re looking for. What’s the procedure like? Alexander JM, Grant AM, Campbell MJ. Randomised controlled trial of breast shells and Hoffman's exercises for inverted and non-protractile nipples. BMJ. 1992;304(6833):1030–2.

I'd recommend using Aquaphor or something similar to help with suction and possibly a bit of dryness around new skin exposure. Also be aware that sensitivity increases right after treating so if you have a significant other give them fair warning. I've had minimal discomfort with the application of suction, but sometimes wearing them for the extended time frame causes mild itching or dull ache around the areola. In our recent breastfeeding support trial [ 21], the attrition rate was 40%. Since women with inverted nipples face more difficulties in breastfeeding than women with normally everted nipples, we hypothesize that 50% attrition rate would be a reasonable assumption for the proposed study. To account for a potential attrition rate of 50%, we inflated the sample size to become 100 women in total. Statistical methods Han S, Hong YG. The inverted nipple: its grading and surgical correction. Plast Reconstr Surg. 1999;104(2):389–95. Breastfeeding confers several health benefits to infants and their mothers, including protection from infectious and chronic diseases, improved child cognition, development, and intelligence, and decreased risks of maternal depression and malignancies [ 1, 2, 3, 4, 5]. As such, breastfeeding is recommended as the exclusive nutrition for the first 6 months of the infant’s life, with continuation until 2 years complemented with solid foods [ 6, 7, 8]. However, women with inverted nipples often have difficulties in maintaining breastfeeding due to improper infant latching that my cause insufficient milk extraction and poor infant satiety, thus leading to early termination of breastfeeding. Congenital inversion of the nipple, the most common nipple deformity, is due to early developmental arrest [ 9], with an estimated prevalence of about 10% [ 10]. However, nipple inversion can also be acquired secondary to mastitis, macromastia, carcinoma, or breast reduction, or can be associated with congenital syndromes such as Robinow and MR/MCA syndromes [ 11]. Han and Hong categorized the severity of inverted nipple into three grades. In grade 1, the nipple is easily pulled out manually, maintains good projection, and has minimal fibrosis. Grade 2 includes the majority of inverted nipple cases in which the affected nipple can be pulled out manually but fails to maintain projection and has moderate fibrosis beneath it. Grade 3 constitutes the rarest type of inverted nipples, which cannot be pulled out manually due to severe fibrosis [ 12].The World Health Organization. The World Health Organization’s infant feeding recommendation. Available from: http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/. Last accessed 17 Dec 2018. Victora CG, Horta BL, Loret de Mola CL, Quevedo L, Pinheiro RT, Gigante DP, et al. Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil. Lancet Glob Health. 2015;3(4):e199–205. If you do decide to get your nipples pierced, note that taking the jewelry out may cause your nipples to invert. To prevent this, avoid leaving the jewelry out for extended periods of time. Eligible subjects are healthy pregnant women, at or above 18 years of age, with grades 1 or 2 inverted nipples. Inclusion criteria are gestation at 37 weeks or more, intention to breastfeed, and residing in Lebanon for 6 months after delivery. We will exclude women with grade 3 inverted nipples, previous breast surgery affecting the breast anatomy, high risk pregnancies, medical conditions that may interfere with breastfeeding, including a critical maternal condition, newborns with congenital malformations such as esophageal atresia, cleft lip, and/or palate, and women choosing artificial milk as their preferred infant nutrition. Women with term twin gestation will not be excluded. Recruiting process