- What are inverted or flat nipples?
- How do I know I have inverted or flat nipples?
- Can I breastfeed with an inverted or flat nipple?
- What are the problems when breastfeeding with inverted or flat nipples?
- How to overcome breastfeeding problems due to inverted or flat nipples?
- When should you worry about inverted or flat nipples?
The health of the mother plays a vital role in determining her ability to breastfeed. That said, all women are capable of breastfeeding no matter what the shape of their breasts is. However, women who have inverted or flat nipples often fret about the problems they face during breastfeeding.
What Are Inverted Or Flat Nipples?
When an adhesion binds the nipple to the tissue at its base, it causes the nipple to sink deep and makes it inverted (1). An inverted nipple may also arise due to shorter milk ducts, which occur naturally and can cause the nipple to sink. About 10-20% of women have inverted nipples, with One or both nipples being inverted (2).
A flat nipple is one that stays flat or flush with the surrounding areola region and is hard to distinguish from the tip of the areola. Women with flat nipples usually encounter the same problems that women with inverted nipples face.
How Do I Know I Have Inverted Or Flat Nipples?
When you check yourself in the mirror, the inverted nipples appear dented inwards and are not erect, as they should normally be. Also, inverted nipples may stick out when stimulated, in colder weather, or sometimes without any stimulation. A pinch test helps you determine if your nipples are flat or inverted.
Gently pinch at the edge of the areola, where the nipple is. If the nipple stays the same or dents further inwards, then you have an inverted nipple. A true flat nipple will protrude a bit when pinched. In the case of flat nipples, the tip of the nipple is also visible when you pinch.
[ Read: How To Get Rid Of Engorged Breasts ]
Can I Breastfeed With An Inverted Or Flat Nipple?
Yes, you can! You can breastfeed your baby as usual even with an inverted or a flat nipple. The breasts produce the same amount of milk irrespective of the shape of the nipple. While infants seldom have a problem feeding from an inverted nipple, some mothers find it challenging.
What Are The Problems Of Breastfeeding With Inverted Or Flat Nipples?
Following are a few problems that you could encounter while breastfeeding with a flat or an inverted nipple (3).
- Babies may have difficulty latching on to inverted and flat nipples, as they may not provide adequate suction for it.
- The latch is frequently broken, disturbing the baby’s feed time. This happens when the baby is drowsy and slowly loses grip of the nipple.
- Poor latching may cause the baby to feed insufficiently, which in turn results in or inadequate feeding overall.
A good latch is usually the leading issue, but there are ways to overcome the problem.
How To Overcome Breastfeeding Problems Due To Inverted Or Flat Nipples?
If the baby is having trouble breastfeeding from inverted nipples, then you can consider the following solutions:
- Shape the nipple before insertion: Before feeding, gently squeeze and roll the areolar region to make it more pointy so that the baby can latch better. You can also gently pull out the areolar region or the nipple with your index finger and thumb and insert it into the baby’s mouth.
- Try Hoffman’s exercise: Also called the Hoffman technique, this is a simple, harmless technique to stretch and ease out the inverted nipple. Place your thumbs on either side of the nipple such that they are opposite to each other. Now gently drag the thumbs away from each other while pulling at the skin, to stretch the nipple out. Repeat the action five times.
Now stretch the areola in a vertical direction by placing the thumbs above and below the nipple, and repeat the action five times. Try these methods just before you breastfeed the child. While the exercise does not rectify inverted nipples, it helps the infant latch on better to the breast (4).
- Wear nipple shells: Plastic nipple shells are a pair of hard plastic concave plates that slip into your bra to shield your areola and the region around it. Several women found that wearing nipple shells helps draw out the nipple enough to feed the baby (5). You can check for shells certified by the International Board of Lactation Consultant Examiners (IBLCE) if you like.
- Feed through nipple shields: Nipple shields are a pair of silicone nipples that go over your nipples. Unlike nipple shells, nipple shields are made of soft silicone and cover only the areola region of the breast. These shields are available in different sizes and have tiny holes to allow the passage of milk. Pick the right-sized shield that the baby can easily latch on to.
- Pump out some milk before feeding: If nipple shells and shields do not work, then you can consider pumping out some milk before feeding. This improves the nipple shape and makes it easier for a baby to feed.
- Consult lactation consultant: If none of these techniques help the baby breastfeed better, or if you have doubts about any of these methods, then consult an IBLCE-certified lactation expert.
[ Read: What Causes Mastitis ]
When Should You Worry About Inverted Or Flat Nipples?
Inverted and flat nipples can create a few complications:
- Baby is unable to feed: In some extreme yet exceptional cases, a baby cannot latch on to an inverted nipple in spite of repeated efforts. Surgical correction of the nipple through plastic surgery can be an option, but may not be recommended if you are actively breastfeeding. The doctor may suggest pumping milk and feeding it through a bottle as an alternative.
- Inverted or flat nipple appears suddenly: If you have always had an inverted or flat nipple, then there is nothing to worry. But if you just noticed a change in the shape of your nipple, then consult a doctor (6). An inverted nipple is often an early sign of breast cancer, but it is not conclusive of the condition!
An inverted nipple could just be engorgement or mastitis (breast bacterial infection) that may change the shape of the nipples. These conditions can be treated with rest and oral medication.
No two humans are alike, and neither are their anatomies. So you may have one or even two inverted nipples, or differently shaped nipples. As long as that doesn’t affect your ability to breastfeed, you have nothing to worry about. If it does, talk to a lactation expert or a doctor right away and get help. The most important thing here is to help your baby get the necessary nourishment, no matter what.
[ Read: Breastfeeding With Nipple-Piercings ]
Have any questions or experiences to share about inverted nipples? Then do share it with us in the comment section below.
2. 6 Little-Known Facts About Nipples; University of Maryland
3. Flat or Inverted Nipples; Thomas Jefferson University Hospitals
4. J. M. Alexander, A. M. Grant, and M. J. Campbell; Randomised controlled trial of breast shells and Hoffman’s exercises for inverted and non-protractile nipples; BMJ (1992)
5. Reviewed by T Dozier and C Rosen-Carole; Techniques for flat or inverted nipples; University of Rochester
6. Symptoms of breast cancer; Canadian Cancer Society
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