Effect of Hoffman’s Exercise Versus Inverted Syringe Technique on Nipple Length and Breastfeeding Outcomes among Primiparous Women with Inverted Nipples.

Background: First-time breastfeeding mothers with inverted nipples often encounter difficulties with breastfeeding due to insufficient infant latching resulting in inadequate milk extraction, maternal dissatisfaction, and unsatisfactory infant satiety, ultimately leading to premature breastfeeding termination which deprives the infant of the optimal nutrition provided by mother's milk. Therefore, this study aimed to evaluate the effect of Hoffman’s exercise versus inverted syringe technique on nipple length and breastfeeding outcomes among primiparous women with inverted nipples. Design: quasi-experimental research design was used. Subjects: A convenient sample of 60 primigravida women was recruited from the antenatal outpatient department of Mansoura university hospital. Three tools were used to collect data; Tool I: Basic data structured interview questionnaire; Tool II: "Modified Via Christi Breastfeeding Assessment tool"; Tool III: "Breastfeeding Self-Efficacy Scale Short Form (BSES-SF)". Results: the study revealed that 67.4% of the nipples of women who applied Hoffman's exercise compared to 57.2% of women in the inverted syringe technique group became everted. Also, breastfeeding level was adequate in 66.7% of Hoffman's exercise group and 42.2% of the inverted syringe group. The mean score of breastfeeding self-efficacy was 55.17±12.34 in Hoffman's exercise group compared to 42.63±11.21 in the inverted syringe technique group Conclusion: The results of the current study have demonstrated that Hoffman's exercise exhibited a superior effect compared to the inverted syringe technique however, women with Grade I inverted nipples who received both interventions experienced a satisfactory increase in their nipples' lengths subsequently, the level of breastfeeding adequacy and breastfeeding self-efficacy showed positive results. Recommendations: Hoffman's exercise and inverted syringe technique are recommended to be integrated into the routine nursing care measures of women with flat or inverted nipples as both interventions have proven simplicity and effectiveness.