The Evert-It™ Nipple Enhancer
The Evert-It™ Nipple Enhancer
The Evert-It™ Nipple Enhancer is a medical device used in assisting the correction of inverted or flat nipples and engorgement of the postpartum lactating mother, by everting the nipple. Enhancement allows an infant to latch-on and suckle if natural breastfeeding is desired by the mother. The care and advice given to a new family during the days immediately after birth is extremely important in the successful establishment of breastfeeding. Effective interventions can mean the difference between a positive breastfeeding experience and a negative one. New mothers are in a particularly vulnerable state emotionally and have limited physical and emotional reserves. They often feel pressure to have breastfeeding well established by the time of hospital discharge.
One of the most common breastfeeding challenges, and one that can jeopardize the success of the breastfeeding relationship, is when a woman has flat, inverted or retracting nipples and/or poorly protractile nipple skin. The baby may have difficulty latching on to the breast properly. Nipple shape (or lack of) is certainly one determinant of the infant's ability to latch-on appropriately. When a mother has nipples that do not protrude, the infant does not receive the touch (tactile) cues that would be given by a firm, everted nipple; either while eliciting a wide open mouth or pulling the baby onto the breast. A nipple retracts or inverts because tiny bands of connective tissue, or adhesions, attach the nipple to the inner breast tissue, pulling the nipple inward. There are different degrees of nipple inversion and it is not uncommon for a woman to have one flat or inverted nipple while the other protrudes more. Protractility of the nipple and surrounding tissue is at least as important to latch-on as nipple shape. It is this factor that enables the infant to be able to draw the breast far enough back into their mouth to ensure an adequate transfer of milk. Good latch-on means the baby's mouth and gums will bypass the nipple entirely and grasp the areola for effective breastfeeding. Once the baby is properly attached to the breast, the suckling action will further improve the protractility of the nipple skin.
Prior to the Evert-It™ Nipple Enhancer, treatments have included nipple exercises, use of breast shells to be worn between feedings, use of a breast pump before feedings to draw the nipple out or nipple shields that are worn over the nipple during feedings. Some of these treatments may be costly and others have limited effectiveness. The use of the Evert-It™ encourages the nipple to protrude and can improve the protractility of the surrounding tissue for easier latch-on in the first few days of breastfeeding. Use may be discontinued as soon as the infant has become proficient at breastfeeding.
Engorgement may intensify existing latch-on problems (or create problems for an infant who was going to breastfeed well when the breast was soft) by making the nipples flatter and the areola harder. Repeated use of the Nipple Enhancer right before feedings can draw milk out of the breast and increase nipple protrusion to correct the situation.
The Evert-It™ is centered over the nipple and the mother is instructed to pull back on the plunger with one hand, while holding the barrel of the syringe with the other (note: this can also be done with one hand). She should pull out the nipple to a level that is comfortable and maintain this pressure for 30-60 seconds. If she experiences pain at any point, she is instructed to push the plunger back to decrease the suction.
In creating the vacuum or suction, the soft tissue of the nipple is stimulated, causing the inverted or flattened nipple to become more defined and erect. The more vacuum created, the more profound the nipple definition. Once the nipple is sufficiently defined, the suction is broken at the skin, the device is removed and the infant is pulled quickly to the breast for latch-on.
After the device is removed, the nipple may revert to its original position, so it is best to use the Evert-It™ just prior to attempting to latch the baby on. The mother may repeat the procedure up to three times before latch-on, and several times a day in between feedings to improve nipple protractility.
The Evert-It™ is packaged in a durable container and may be washed with hot, soapy water or boiled after use.
For more information reference our Frequently Asked Questions, Clinical Trial Summary and User Testimonials.
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