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Breastfeeding with Inverted Or Flat Nipples

While new parents hope and imagine that breastfeeding will be a completely easy, natural and rewarding experience, this is not always the case. One of the things that may make breastfeeding more of a challenge for some moms is having flat or inverted nipples.

Are your nipples flat or inverted? How will this affect your ability to breastfeed your child?

Our first piece of advice is to remain calm. Many people who have flat or inverted nipples successfully breastfeed their babies. Sometimes, it is not even necessary to use any special techniques or tools, especially if the inversion is slight.

Even those with severe nipple inversions may be able to breastfeed using the right tools and techniques. Let's take a closer look at what it means to have flat or inverted nipples and how this may affect your ability to breastfeed your baby.

A Word of Encouragement

Remember that your baby will feed from your breast, not just the nipple. Ideally, your baby's mouth and gums will go over the nipple to latch onto the areola, which is the darker tissue that surrounds the nipple. Because of this positioning, it may be that flat or inverted nipples will have little to no effect on how well your child can feed from your breast.

Remember to be patient, check for a good latch and make sure that you're using good positioning techniques to have the best chance for success.

Do You Have Flat or Inverted Nipples?

After giving birth, some moms are surprised to learn that their nipples are considered flat or inverted. Sometimes, it is a lactation consultant who points this out. However, it is possible for you to determine whether or not your nipples are flat or inverted.

This may not be obvious by simply looking at your nipples. Fortunately, you can perform a quick and easy test. Called a "pinch" test, this merely involves compressing your areola about an inch behind your nipple. Gentle compression is all that is required.

If the nipple does not become erect when compressed, then it is probably flat. A nipple that becomes concave or retracts when gently compressed is considered inverted.

Keep in mind that a truly flat or inverted nipple typically does not react to stimulation or when exposed to cold. A nipple that becomes erect during a pinch test is not genuinely inverted and should not need any special consideration or treatment.

Not All Inverted or Flat Nipples Are Alike

It is not always easy to tell if nipples are flat or inverted. That's especially true because not all flat or inverted nipples are alike. Here are a few of the variations:

  • Dimpled: Part of the nipple may protrude. If you pull out the nipple, it will not stay that way
  • Unilateral: One nipple may be flat or inverted while the other is not
  • Slight Inversion: This type of inversion is mild. A baby who is capable of a normal suck may have no difficulty with this condition.
  • Moderate to Severe Inversion: Nipples with this degree of inversion deeply retract when compressed. Babies may have difficulty latching on and breastfeeding. Deep-latch techniques and other treatments may be able to address this condition.

Treatments and Techniques that Help with Flat or Inverted Nipples

There is a considerable debate with regard to when treatment for flat or inverted nipples may begin. While some experts say that treatments may be helpful during pregnancy, others say that it is wiser to wait until after giving birth. When in doubt, consult with your doctor, midwife, lactation consultant or other healthcare professional for guidance and advice.

When treatment is recommended, it may come in one or more of these forms.

Breast Shells

Two-piece breast shells are made of plastic and are worn inside the bra. The inner piece of the breast shell fits directly over the nipple, exerting slight pressure. The nipple protrudes through the hole because of this pressure.

Frequently, breast shells are recommended for use by pregnant women who have flat or inverted nipples. The increased elasticity of the skin that is a natural side effect of pregnancy helps to draw the nipple out of its inversion.

New mothers may want to wear breast shells for approximately one-half hour before feedings, but it is critical to not wear them at night and to not attempt to save the milk that may collect inside the breast shells.

Breast Pumps and Modified Syringes

Breast pumps are useful tools for many new parents. In addition to providing moms with a way of extracting milk for later feeding to their babies, breast pumps may help to evert inverted nipples or to improve expressing milk from flat nipples. Of course, it is vital that the breast pump has properly sized flanges in order to ensure optimum operation.

Similarly, studies have shown that using modified syringes also may help with breastfeeding challenges. These also may be called nipple aspirators. Inexpensive and easy to use, a modified syringe or aspirator sometimes is able to completely transform the breastfeeding process.

Look for a Product That's Designed to Evert Nipples

Typically, these are suction devices that may be called nipple extractors, cups or shells. Designed to stimulate the nipple, these devices pull the nipple into a cup. This action is believed to loosen up nipple tissue, making it more likely that nipple may protrude on their own. No research supports the use of these devices at this time. However, most are inexpensive, and anecdotal evidence suggests that they can work, so it may be worth trying any of them.

Stimulate Nipples Before Feeding

Some inverted nipples may respond to rolling between the thumb and forefinger for a couple of minutes. After rolling, touch the nipple with an ice cube wrapped in a cloth. Make certain that the touch with ice is brief, as prolonged contact with ice may numb the nipple and have the opposite of the desired effect.

Try Reverse Pressure Softening

Before a feeding, circle you’re the base of your nipple with your fingertips. Push in toward your chest for between one and three minutes. This technique may push other fluids aside while also stimulating the flow of milk and causing the nipple to protrude, which allows for easier latching.

Pull Back on Breast Tissue

As your baby latches on, support the breast with your fingers on the bottom and your thumb on the top. Your fingers are positioned just behind the areola. Use your hand to gently push your breast tissue toward your chest, which may cause your nipple to protrude.

Implement Good Breastfeeding Techniques

For moms with flat or inverted nipples, it is especially critical to use tried-and-true techniques. Nurses at the hospital may provide excellent early advice, but it can be even more helpful to work with a lactation consultant to get more tips if feedings are a challenge.

You'll probably be encouraged to begin breastfeeding while you're still in the hospital after giving birth, and it's frequently wise to keep breastfeeding every two to three hours. Breastfeeding with this level of frequency prevents the breasts from becoming engorged, which leaves them softer. This makes it easier for babies to latch on to a flat or inverted nipple.

Crucially, lactation consultants can provide guidance with positioning and latch-on. Your lactation consultant may be able to suggest a variety of different positions that may be more comfortable for you and encourage your baby to achieve a stronger latch. Here are a few examples of various breastfeeding positions:

  • Cradle Position
  • Cross-Cradle Position
  • Clutch Position
  • Side-lying Position

A lactation consultant can introduce you to each of these positioning techniques so that you may try them all and determine which one works best for you and your baby.

Let Euphoric Herbals Help

If you want to ensure that your baby has the best start possible, then consider the lactation-supporting products that are available through Euphoric Herbals. Our Milky Mama Tea contains healthy, gently stimulating ingredients such as a red raspberry leaf, alfalfa leaf, fennel seed, blue vervain and more to enrich breastmilk and increase production. All herbs used in the recipe are USDA certified organic, so you can feel good about putting them in your body while you're breastfeeding.

With the help of Euphoric Herbals, your baby will be off to a healthy start.