Can I breastfeed with flat or inverted nipples?

inverted nipples

Yes you can!!!

Newborn babies have an extremely strong suck reflex and when your baby latches on, your nipple will double in length in the baby’s mouth!!

If you have flat nipples, the key to breastfeeding success is getting your baby latched on within the first hour.  However, if this doesn’t happen and your baby is having difficulty finding your nipple there are many things you can try.

Flat Nipples

However it is worth knowing firstly, what kind of nipples you have and whether they have the potential to cause issues for you. If you have a nipple that looks flat, you should try the pinch test (where you pinch the base of your nipple to see how it responds). Most nipples will become erect and stick out after the pinch test and if it does, your flat nipple should not be a cause for concern at all.

Nipple Pinch Test (MilkandHugs.com)

If however, your nipple sinks back into your areola (goes underground) after the pinch test, this is called a retractile nipple and may cause some issues for you.

So what can you do for a flat nipple that retracts when pinched?

  1. Positioning – Make a sandwich out of your breast in order to push the nipple forward and stimulate your baby’s suck reflex. Or use your index finger to push your breast up from underneath the cause the nipple to protrude.
  2. Nipple suction cups – you can consider wearing these cups from 37 weeks gestation and with your Obstetrician’s approval. Or you can use them for a minute before you attempt to latch baby on .
  3. Nipple extractor’s – This is a nipple cup with a bulb attached that you can use to suck out your nipple just before latching on your baby.
  4. A Silicone Breast Pump –  This can also be used to suck out your nipple. 
  5. Nipple shield – If your baby is not latching on at all and you have tried some of the above, you can use a nipple shield to get your baby latched on, which in itself will help pull out your nipple. Go for the butterfly shaped ones, with the thinnest silicone you can get. Make sure they fit your nipple correctly:  https://blog.breastmates.co.nz/advice-and-tips/expressing-and-pumps/expressing-help/breastshield-sizes-pumps/  and that you know how to apply them correctly:  https://www.laleche.org.uk/wp/wp-content/uploads/2015/12/Untitled-design.png If you do start using nipple shields, I would recommend you seek a Lactation Consultant to assess your situation, as there are downsides to long-term nipple shield use.

Inverted Nipples

Inverted Nipple

Inverted Nipple. Image taken here.

Inverted nipples are nipples that when you look at them appear puckered or invisible. These can be a little trickier to deal with, and if you have a nipple like this I would advise you to discuss this with your local Lactation Consultant.

Inverted nipples are caused by muscles around the areola that pull the nipple outside in. If you do the pinch test and your nipple pops out easily, you may have no issue with breastfeeding your baby. If however, your nipple doesn’t come out easily, it can be more difficult, and you will need skilled help from a Lactation Consultant.

If you have inverted nipples (you have one inverted and one normal), you will have to be more mindful of nipple care. This is because your inverted nipple tissue has never seen the light of day, and all of a sudden it is pulled out repeatedly. Oftentimes, the nipple will return to its original position after feeding, and if it is not dried completely before re-inverting it can cause cracks which will re-open each time the baby feeds, and this can be very painful. Equally, if your baby’s latch isn’t correct and you have nipple damage your nipples can be more difficult to heal if they re-invert. Nipple care is the top priority. See latchingon.ie/…/sore-nipples-and-nipple-care.

For more information on Nipple inversion check out these videos I did on Nipple Inversion: