What led us to pursue this study?

Inverted nipple in lactating mothers is a common issue that doesn't allow the neonate to latch effectively. This leads to delayed establishment of exclusive breastfeeding and prolongs the hospital stay in the neonate. A commonly used method for reversal of inverted nipples in mothers in low-middle income countries (LMICs) is the usage of an inverted syringe technique to pull out the inverted nipples before initiation of breastfeeding. However, we noticed that the mothers experienced pain during this procedure. This led us to explore the alternative methods. We found that the usage of an electric breast pump led to correction of nipple inversion more physiologically. Hence, we conducted this feasibility trial to see if the electric breast pumps were as good as the syringe technique in establishment of exclusive breastfeeding and if they caused less pain. 

What did we find?

We compared the two methods for establishment of exclusive breastfeeding by day 3 and for pain scores in mothers till day 3. For feasibility, we took 30 participants in each group. This was a randomised control trial. We found that establishment of breastfeeding was comparable in both groups. The groups were also comparable for pain scores for the first 48 hours. However, on day 3, the mothers using the electric breast pump had less pain compared to those using the syringe method. 

What are the broader implications?

Through this study, we found that both methods are equally good for successful establishment of breastfeeding in lactating mothers with inverted nipples. The electric breast pump was more comfortable to use as it caused less pain by day 3. Hence, in units with easy availability of electric breast pumps, the same can be used as an alternate method. However, in LMICs, this facility may not always be available. In such a scenario, the syringe method can be used.