Breastfeeding With Flat Or Inverted Nipples

Some types of nipples like concave, flat or inverted nipples might make it more difficult for baby to latch onto. For a baby to nurse successfully he must be able to grasp the nipple and stretch it forward and upward against the roof of his mouth. The most important thing to remember is that baby should get as much of your breast into his mouth as possible.

Flat or inverted nipples are mostly caused by adhesions which never opened up naturally during puberty resulting in abnormal nipples. During nursing there will be some pain as the nipples are pulled out, but just remember it is temporary and the nipples usually start to look normal after a while.

Most of the time you will only have one inverted nipple. In this case, you will be able to feed baby on the “good side” while you pump the other side. You can always just keep the pumped milk for times when baby needs a bottle

Some good news is that the more you breastfeed the larger your nipple will become and the more it will stand out. And the breast-feeding will therefore become easier with every baby.

How do you know if you have flat or inverted nipples?

Gently compress your areola about an inch behind your nipple. If your nipple doesn’t bulge out then it is a flat nipple. If your nipple actually concaves it is considered to be inverted. Flat or inverted nipples will never become erect when stimulated or when cold. If you just have small nipples you should not have a problem with latch on unless you have any of the other problems (explained here)

Treatments:

- Nipple formers - Also called breast shells, milk cups, breast cups or breast shields. These shells are used to help the nipple protrude, they can be worn a few months before baby is born and also every time before a breastfeeding session.

- The Niplette - This is a device that actually sucks out the nipple which stretch the ducts and then make breastfeeding possible.

- The Hoffman Technique - Pressing down and pulling away from the nipple with your thumbs a few times. Do this up and down and sideways. The hoffman process will help your nipple move outwards and can be done about five times a day.

- Using a breast pump - A breast pump can be used every time just before breastfeeding. A pump will pull the nipple out.

- Use the breast sandwich method to get more breast tissue into baby's mouth. Grasp your breast well back on the areola, with your fingers below and thumb on top. Push in with your thumb and fingers and at the same time push back toward your chest wall. This will elongate your areola, which helps baby latch on easier.

- A nipple shield - nipple shields are fake nipples which are not recommended as it may ultimately decrease your milk supply.

- Cosmetic surgery - This option can help with breastfeeding, but some people have said that their nipples become inverted after a while again.

Things you can do that might help:

- Nipple stimulation - You can roll your nipple in your hands or place something cold on it for a few minutes to get it to stand out.

- With an inverted or flat nipple you will need to nurse as soon as possible after birth, and every 2-3 hours after that. This is to avoid engorgement because breast engorgement can push flat nipples out, making them even harder to grip.

- Make sure that your baby is latching on correctly

- Try calming baby.

Use calming techniques

- If you are breastfeeding with inverted nipples you should always remember that baby should get as much of your breast into his mouth as possible.

- As a last resort mom might feel that she would rather pump exclusively

Many moms feel that they want to give up on breastfeeding after a while due to the many different difficulties they might be experiencing during breastfeeding, but can I please encourage you to read our page on the benefits of breastfeeding, not just for your baby, but for your sake too.

Other pages on "breastfeeding problems" in connection with flat or inverted nipples:

- Inspirational breastfeeding stories

- Pumping exclusively - Tips and advice

- Using a nipple shield

- Latching on

- Calming baby

- Nipple pain 

- Oversupply

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