Breastfeeding with Flat or Inverted Nipples

Breastfeeding is a beautiful opportunity for new mothers to bond with their babies while providing the nourishment they need for a healthy development. While many new moms struggle with breastfeeding for a variety of reasons, those who have flat or inverted nipples tend to have more difficulty when it comes to latching. If the latch isn’t strong, your baby won’t get enough milk and your body will subsequently decrease production. However, it’s called breastfeeding, not nipple-feeding. Regardless of what shape or size your nipples are, there are ways for you to provide breast milk to your baby. In this article, we’ll cover breastfeeding with inverted or flat nipples and what you can do if you’re having trouble.

What are Flat Nipples?

Flat nipples are nipples that tend to lay even against the rest of the areola. They don’t protrude outwards or retract inwards. While many nipples look flat without excess pressure or stimulation, flat nipples will not change when the areola is gently pinched, squeezed, and exposed to cold or arousal. Some women have experienced a flat nipple their entire lives while others only experience them temporarily due to engorgement or swelling. If you think that you might have flat nipples during pregnancy, talk to your doctor about what you can do to prepare.


What are Inverted Nipples?

Inverted nipples are nipples that either retract inward when the surrounding skin is gently pinched or squeezed or that, without stimulation, cave in. A lot of inverted nipples don’t appear to be inverted and many women don’t realize they have them until they start breastfeeding. Like flat nipples, inverted nipples can be exasperated by engorgement or swelling. You can easily check to see if your nipples are inverted by gently pinching them and seeing how they react. In severe cases, inverted nipples can make breastfeeding and nursing difficult and may affect the milk flow. Talk to your doctor if you think you have inverted nipples so you can better prepare for successful breastfeeding after delivery.


How to Prepare Flat or Inverted Nipples During Pregnancy

If you notice that you have a flat or an inverted nipple, don’t worry. A lot of women experience a natural protrusion during pregnancy that will help your baby latch post-delivery. There are options to wear nipple formers or nipple shells, which help to draw out your nipple slowly over time. Talk to your doctor or a latching consultant about how to wear nipple shells as they shouldn’t be worn throughout your entire pregnancy and can lead to early contractions if you have a weakened cervix.


Can You Breastfeed with Flat or Inverted Nipples?

Flat and inverted nipples don’t always cause a problem when breastfeeding. As long as your baby can form a strong latch, your nipples will be drawn out and breastfeeding continues as usual. This is good news for babies who have a strong natural suck but can be problematic for those with weaker ones. The appearance of your nipple has no effect on how your breasts produce milk, but without a good latch your baby won’t be able to expel enough milk. The less milk they get, the less milk you make, which can cause problems for your milk supply. If your baby is unable to form a latch due to the lack of protrusion, you may have to perform a few pre-latching techniques.


7 Techniques to Make Latching Easier

To make sure that your baby is latching, there are a few things that you can do prior to starting a nursing session. Work through the list and find something that helps you. If you’re still unable to draw the nipples out, talk to a lactation consultant for more guidance.


  1. Use Breast Shells

    Breast shells help to draw your nipple out over time. They’re like training bras for your areolas. They work by putting a slight pressure around the base of your nipple on the areola to help ease nipples out. As we mentioned above, you can wear these during pregnancy if approved by your doctor and you can continue to use them after delivery.

    Just keep in mind that you can’t wear breast shells while you’re nursing, so make sure that you remove them prior to latching. 


  2. Try Nipple Shields

    Nipple shields work similarly to breast shells, but they can be used during nursing. The nipple shield fits over the nipple and areola and can help pull out your nipple for latching. If you plan on using nipple shields during nursing, make sure that you talk to your doctor or a lactation consultant to fully understand how to do so and the associated risks. There is some evidence that has suggested that a nipple shield may reduce the transfer of milk and interfere with complete breast emptying. Other research shows that nipple shields can cause nipple confusion or lead to a preference over the natural breast.


  3. Pre-Feed Breast Pump

    The suction from breast pumping right before you nurse your baby can help elongate your nipple and prepare for a stronger latch. Breast pumping also stimulates the nipple, which is extremely helpful if you have inverted nipples. There are plenty of great options for breast pumps online and thanks to the Affordable Care Act, new mothers are eligible to receive a pump free of cost.


  4. Ease Engorgement

    If your nipples are flat or inverted due to engorgement, try easing the swollenness by breast pumping or using a warm compress. If you decide to pump, just make sure that you don’t overdo it. Your milk ducts work on a supply and demand cycle so emptying them too much can make engorgement worse.

    A great way to ease engorgement is to hand express. This helps to soften your breast and encourage a deep latch. Hand expressing can be done whenever you’re engorged or right before nursing. This technique is also referred to as reverse pressure softening.


  5. Find the Perfect Product

    There are certain products that can help bring out the nipple without expelling milk. A nipple everter can be used prior to nursing sessions. It’s a handheld suction device that you can put over your nipples to draw them out using gentle suction. Some women prefer this to breast pumping as you don’t expel any milk during the process and can be done quickly with complete control.


  6. Stimulate Nipples

    Some women find success through light stimulation right before nursing. Try gently rolling the nipple between your fingers or applying a cold cloth to help draw it out. You can use the Hoffman technique on either one or both of your breasts. It’s proven to be successful and has been used since the 1950s by women to aid in breastfeeding. By undergoing regular stimulation, your nipples may start to protrude more often.


  7. Breastfeed Often

While it can be frustrating at first, the more you breastfeed the better it will get. Over time, the consistent sucking on your nipple can help it become more protruded and make the process easier. While a lot of new mom struggle to breastfeed, that doesn’t mean it’s impossible. The more often that you nurse your baby, the easier it will get. By combining one or more of the above techniques in addition to frequent, responsive feedings, you’ll start to notice improvements. If you don’t, reach out to a lactation consultant for more guidance.


Dealing with Nipple Soreness

Nipple soreness occurs with many new moms at the beginning of breastfeeding but can be a little more intense for those with a flat or inverted nipple. During this time, your baby’s nursing and the use of a breast pump is gradually working to draw out the nipple. It’s understandable that you’re going to be sore, but the soreness shouldn’t persist for over two weeks. If your skin remains tight, it can create a stress point that may lead to cracks or blisters. This can become problematic for women who have deep inversions but there are measures you can take to correct the nipple. Talk to a lactation consultant if you’re having trouble to learn how to properly draw out the nipple without trauma or pain.

Nipple soreness also commonly occurs to due dry, cracked skin. To help avoid this, try using a nursing safe nipple cream to keep your skin well moisturized.


Getting Help from a Lactation Consultant

If you’re still having trouble breastfeeding with flat or inverted nipples, don’t hesitate to reach out to a lactation consultant. Lactation consultants can help you get past whatever difficulties you’re facing to find a solution that will result in your baby being nourished exactly how they need to be for development. Alongside your insurance covered breast pump, many lactation consultants are covered through insurance for new moms who need the extra help. For more help on all things pregnancy, breastfeeding, breast pumping, and delivery, check out Byram Healthcare’s blog today.