The Hoffman technique

I am pregnant with my third child and I had a lot of problems nursing my first two children, due to flat and very sensitive nipples. I wore nipple shells in my bra during my last pregnancy and this helped a little but not nearly enough. I have heard about a prenatal exercise called the Hoffman Technique and was wondering if you could either describe this.


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Breast shells and nipple preparation (the Hoffman Technique) are often recommended to help evert flat or inverted nipples. There are no studies to conclusively prove the effectiveness of using either of these prenatally, to help break the adhesions and draw out the nipples.

The Hoffman Technique (Hoffman, 1953) is intended to loosen adhesions. Place your two thumbs opposite each other at the base of your nipple. Press firmly and at the same time, pull the thumbs away from each other. Rotate the thumbs around the base of your nipple. This should be done five times each day. Discuss use of this technique with your Health Care Provider if you have a history of premature birth, or factors currently predisposing you to premature labor. I would not recommend starting this technique until the last trimester of pregnancy. The hormones of pregnancy often help to loosen adhesions without any interventions.

With flat or inverted nipples, it is particularly important to put your baby to your breast as soon after the birth as possible. Allowing your newborn access to your breast in the first hour or two has an imprinting effect.

Avoid bottles and pacifiers in the hospital and at home during the first six weeks. It seems to be particularly difficult for babies to go back and forth between artificial nipples and the breast when their mom has flat or inverted nipples.

Many mothers have success in drawing out their nipples for a feed by using a breastpump for a couple of minutes before nursing. This is usually only necessary during the first week or two. Work with a Lactation Consultant to help assure good positioning and attachment. Proper positioning is very important for all moms, but especially for those with flat or inverted nipples. Best wishes!

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