Supple Cups
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Designed to help gently stretch flat or inverted nipples making it easier for baby to get a better latch.  (Unlike a nipple shield this product never goes in a baby's mouth, always remove Supple Cups from the breast before latching.)  Supple Cups can be used during the last few weeks of pregnancy or after the birth.

 

FAQ’s about Supple Cups

 

How to Size:

  • Size 1 =    11 mm (rarely used) 
  • Size 2 =  12.5 mm (average)
  • Size 3 =  14.5 mm
  • Size 4 =  16.5 mm

Supple Cups come in different sizes according to the diameter of the mother’s nipple and may vary from woman to woman (similar to the way that shields in breast pumps vary in size).  A mother may even need a different size for each breast.  Supple Cups range from size 1 (the smallest) up to size 4 (the largest).  Many Lactation Consultants find that when trying to gauge the size of the nipple it is best to start with a size 2 and go up a size as needed.  The size 1 cups are rarely used for breastfeeding mothers.  If the nipple can’t be measured it is best to start with a larger size (such as a size 3) and then work your way down to a size that fits comfortably.  A larger size is needed whenever the nipple shows any signs of blanching.  The correctly sized Supple Cup will cover the nipple only and will minimize the amount of aerola that will be pulled into the cup.  The Supple Cup should always feel comfortable to the mother. 

Sizing for Edema and/or Engorgement: Mothers experiencing edema and/or engorgement will need a size that matches the diameter of the nipple. 

Sizing for the Graded Inverted Nipples:  Mothers with an inverted nipple that is a Grade 2 will need a size that matches the diameter of the nipple.  Mothers with a Grade 3 nipple will usually require a Supple Cup that is larger than the diameter of their nipple at first as the cup will draw in both the aerola and the retracted nipple.  As the stimulation from the Supple Cup begins to evert the retracted nipple (this may take several sessions of use) a smaller size cup may be needed as there is no longer any need to draw the aerola into the cup.  The larger sizes (size 3 & 4 Supple Cup) are used most often with the prenatal mother who has a Grade 3 inverted nipple.  Until the nipple begins to emerge the cup needs to be big enough to take in parts of the areola.  After the nipple has initially emerged she may need to switch to a smaller size.

 Note: Unlike Supple Cups, nipple shields, which also come in different sizes, are fitted to the baby’s mouth not to the mother’s nipple.  Nipple shields are a product for the baby, while Supple Cups are intended solely for the use of the mother.  Supple Cups are never to be placed in a baby’s mouth!

Grading Flat & Inverted Nipples:

  • Grade 1 - the nipple that needs stimulation to evert (the “shy” nipple).
  • Grade 2 – the nipple that can be coaxed out, but then retracts (most inverted nipples fall into this category).
  • Grade 3 – the nipple that is hard to evert due to severe fibrosis (the “tethered” nipple).  Most plastic surgeons consider a woman with a Grade 3 nipple as being “unable” to breastfeed.

Note – Long term use of Supple Cups often results in lowering the category of the graded nipple by at least one grade (even after weaning).  A Grade 2 nipple usually becomes a Grade 1 nipple in most cases.  In some (but not necessarily all) a Grade 3 nipple may become a Grade 2.

Prenatal & Postpartum Use of Supple Cups For Inverted Nipples:

A mother who has been identified with flat or inverted nipples may use Supple Cups as a way to assist in permanently everting the graded inverted nipple either prenatally or postpartum.  Typical outcomes show that long time use of Supple Cups results in decreasing the gradation of the nipple by at least one grade.  It is recommended that the mother begin by using Supple Cups for 15 to 30 minutes a day and slowly increase (as tolerated) up to two sessions of two hours a day (four hours in total), but never longer than eight hours per day.  (It may be necessary to place a breast shell over each cup in order to keep it in place under clothing.) Warning: Wearing Supple Cups over-night is not recommended. 

Inverted Nipples / Prenatal Use: Prenatally Supple Cups may be worn beginning in the 37thweek of pregnancy for long periods each day.  Warning – Supple Cups are only recommended for use during normal, low risk, healthy pregnancies.  Excess nipple stimulation may trigger uterine contractions and in rare cases may even be associated with an early labor.  Wearing the Supple Cups longer than four hours per day, or stimulating the nipples by hand while wearing the Supple Cups, is not advised.

Inverted Nipples / Postpartum Use: For mothers whose nipples were inverted prior to pregnancy long term use of Supple Cups may assist in permanently changing the status of the nipple.  (Note: if the breast is leaking copiously the Supple Cups may not seal properly, in which case it would be better to wait until there is less leaking.)                                            

Postpartum Use of Supple Cups For Edema and/or Engorgement:

In addition to aiding in everting the graded inverted nipple, Supple Cups may also be used to temporarily evert flat nipples caused by edema or engorgement.  The Supple Cups need only be applied for a few minutes prior to feeding.  This can be done by the mother herself.  Unlike a nipple shield the Supple Cups never go in a baby’s mouth.  (The cups may also be used to collect drops of hand expressed colostrum, which can then be fed to the baby directly from the Supple Cup!) 

   Note: Supple Cups are not recommended for mothers with cracked or bleeding nipples, or who are experiencing extreme nipple soreness. 

How to Apply:

Supple Cups are simple and easy to use.  Lightly apply a trace amount of baby safe nipple gel or ointment to the base and sides of the nipple.  This acts as both a lubricant and a seal.  Place the cup over the nipple and allow the rim to seal to the skin, then pinch the cup slightly to release a little air, or push down slightly on the top of the cup.  Make the seal first, then pinch (many people make the mistake of pinching the cup before applying to the skin).  This creates a vacuum which will assist in gently pulling out the nipple (a little air will remain in the cup).  Unlike products with a hard surface, the Supple Cups will collapse softly around the nipple regardless of the nipple’s shape.  In other words the Supple Cups will adjust to the shape of the nipple rather than forcing the nipple to adjust to the shape of the cup.  Best of all, the mother can put them on herself without assistance!  Supple Cups should always feel comfortable to the mother!

Note - Breast milk does not create a good seal, it can even cause the seal to release.  Supple Cups may not work if there is significant milk leakage.

Cleaning:

It is recommended that Supple Cups be sterilized once a day and cleaned between uses.  Like most lactation tools Supple Cups are considered a single user item.  Supple Cups may be used continually by the same mother as long as they are properly cleaned and maintained.  It is not recommended that Supple Cups be shared with more than one user.

   To Sterilize - Supple Cups are both autoclave and dishwasher safe.  Cover Supple Cups in water when sterilizing in a microwave. Supple Cups may also be sterilized by placing in boiling water for 5 to 10 minutes. 

   To Clean – Supple Cups may be hand cleaned in hot soapy water and air dried.  Should there be any difficulty in removing the residue from the applied nipple gel try mixing a few drops of vegetable oil with a drop of liquid soap before washing.  

Note - For the mother or baby has been exposed to thrush (or any other disease or condition that may be passed on by skin to skin contact) it is important to avoid cross exposure.  Wash the Supple Cups frequently, and avoid contaminating the unaffected breast.  It is best to assign an individual cup to each breast. 

Published Studies: 

 The Use of Supple Cups for Flat, Retracting, and Inverted Nipples 

Clinical Lactation Vol 2, Issue 3 (2011): 30-33

Julie Bouchet-Horwitz, FNP-BC, IBCLC, RLC

Abstract

Approximately nine to ten percent of women present with flat, retracting or inverted nipples, making latching an infant to the breast more difficult. Various products including breast shells, the Niplette™, the Latch Assist™, an electric pump, and a converted syringe are recommended to help elongate and stretch the nipple in order to assist with latching the baby. A new product called Supple Cups is available that gently stretches and elongates the nipple, making latching easier. Twelve women with flat, retracting, or inverted nipples who were pregnant or having difficulty breastfeeding were asked to try Supple Cups. Ten of the twelve women (83%) were able to consistently latch their babies and breastfeed after using Supple Cups. Eight women (67%) eventually exclusively breastfed their infants. In summary, Supple Cups are an inexpensive, easy-to-use product that can be very effective at protracting flat, retracting, and inverted nipples.

 http://www.clinicallactation.org/abstract.php?id=34&journal_id=7 )

  • Item #: SC001

Supple Cups

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