Breastfeeding With Flat Or Inverted Nipples
Breastfeeding with flat or inverted nipples might not pose a problem for some women.
For others, breastfeeding can be extremely difficult.
The good news is that it’s not uncommon so there are tried and true methods for breastfeeding with flat and inverted nipples!
Table of Contents
- Breastfeeding With Flat Nipples
- Breastfeeding With Inverted Nipples
- Inverted and Flat Nipples During Pregnancy
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Breastfeeding With Flat Nipples
Breastfeeding with flat nipples is more than possible, many moms don’t have a problem with it!
Your baby can latch on to your skin in other places, like your neck, and leave a hickey…
So there’s no reason they can’t latch on to your breast even if you have flat or short nipples.
Your baby actually knows exactly how to find your nipple – even if it isn’t pronounced. Your breasts have a natural couture and your nipples are different than the skin on the rest of your breast. Additionally, your nipples have montgomery glands that give off a smell, leading your baby right to your nipple!
Flat nipples will often change during pregnancy and become more pronounced for breastfeeding.
Sometimes engorgement or too many IV fluids in labor can cause your nipples to appear flat. Once the overfullness of your breasts subsides, generally your nipples will return to normal.
The best news for moms breastfeeding with flat nipples is…
Babies breastfeed not nipplefeed.
As long as your baby can latch deeply on to your breast, you will be able to breastfeed successfully!
There are cases though when a baby has difficulty. When your nipple touches the top of your baby’s mouth, it triggers their suck reflex.
Some babies (especially premature ones) won’t suck unless that reflex is stimulated.
If your baby starts to suck when you place your finger in their mouth upside-down (so your finger pad is touching the top of baby’s mouth), but they don’t suck when latched on to the breast then they may need a little help.
Keep reading for what to do if you encounter challenges when breastfeeding with flat nipples.
What do flat nipples look like?
Wonder if you have flat nipples?
Well, you might think you have flat nipples if they appear that what unstimulated. But if you can rub or touch them (or get them cold) and they protrude, then your nipples aren’t truly flat. In this case, they are just “short-stemmed”
Truly flat nipples don’t protrude off your breast, even with nipple stimulation.
They don’t stick out at all, but they also don’t have a dimple or go inward… that is an inverted nipple.
If you have flat nipples, the BEST thing to do it try and latch your baby deeply onto your breast. Try some of the following tips when breastfeeding with flat nipples.
Breastfeeding With Flat Nipples Tips
Here are some things you can try when breastfeeding with flat nipples:
- A Sandwich Hold.
- Press your breast between your thumb and forefingers (you can also compress it between your first two fingers). What you’re trying to do is make your breast more like a sandwich for your baby to latch on to. If you compress your breast so it’s flatter, your baby will be able to bring more of your breast tissue into their mouth to breastfeed.
- Master A Deep Latch.
- It’s not always easy to latch your baby when breastfeeding. In order to establish a deep latch, start with your baby’s nose to your nipple. Your baby will smell your milk and open wide – then latch them to your breast. Try to latch their bottom lip first and make sure they are opened wide when latching. This pairs well with a sandwich hold.
- Reduce Engorgement.
- If the reason your nipples are flat is because of engorgement, try and resolve the problem. You can pump a little bit before breastfeeding to make your breasts softer (which will also draw out your nipples).
- Or you can try reverse compression. With reverse compression, start at your nipples and press your breast tissue backwards towards your chest. It helps move the milk from the front of your breasts, making them softer and easier to latch on to.
- Consider A Nipple Shield.
- Generally, I try to avoid the use of nipple shields. But they can be useful if a baby’s suck reflex isn’t triggered because of a short nipple. If using a nipple shield triggers your baby to suck, then it might be helpful. They should only be used short term… your baby will be able to breastfeed without it as they get older. Nipple shields can also affect milk supply so be aware of your breasts and make sure your baby is gaining weight well.
- The best nipple shields in my opinion are these ones. They are shaped more naturally, like a breast. They may be helpful when starting out the breastfeeding journey, and I find these nipple shields are the easiest to wean off of.
- Avoid Bottles And Pacifiers.
- For babies struggling to breastfeed with flat nipples, it’s best to avoid bottles and pacifiers. The first option is a nipple shield, and you can use a cup if you need to supplement. Using bottles and pacifiers confuses babies because they are a very long nipple.
- Often with time and patience, babies will breastfeed normally even when mommy has flat nipples. Bottles and pacifiers can lengthen the process and confuse the baby.
How to Make Flat Nipples Stick Out for Breastfeeding
Some nipples that appear flat will protrude with a little manipulation or stimulation. Sometimes it helps to try and make your nipples protrude before a feeding.
Often women with flat nipples notice that pregnancy changes their breasts and their nipples. Other women worry about how flat nipples might affect breastfeeding but don’t have any problems at all.
Here are some things you can try to make your flat nipples stick out for breastfeeding:
- Rub or fiddle with your nipple to make it more pronounced. Try rubbing your nipple between your thumb and forefinger.
- Touch your nipple with a cold compress or ice cube before feeding.
- Try hand expressing or pumping before breastfeeding.
- Use your finger to press up under your breast to make the nipple more pronounced.
- Try using breast shells or a device that pulls the nipple out.
The most important thing to do is feed your baby, and secondly keep your milk supply up. Try these things, but if your baby isn’t transferring milk properly it may help to talk with a lactation consultant.
Some babies have a hard time breastfeeding when moms have large nipples. They will be able to breastfeed with time as their mouth grows so in the meantime you can pump and give your baby expressed milk! Then when they are bigger and stronger they will be able to breastfeed fine.
Breastfeeding with Inverted Nipples
Breastfeeding with inverted nipples can pose a problem for some mommies and babies. If you have inverted nipples, don’t be afraid to try breastfeeding! Some babies do just fine and even pull your nipple outwards while they breastfeed.
Before you worry about breastfeeding with inverted nipples, try it first! You might find that there’s no issue.
But if it is severely painful, baby can’t latch, or isn’t getting enough milk then keep reading for what to do.
What Do Inverted Nipples Look Like?
Inverted nipples look like your nipple going inward towards your chest wall. It might look like a dimple in the middle of your areola instead of a protruding nipple. Sometimes normal or flat nipples will invert, but inverted nipples are constantly pulled inward.
Here is how to tell what inverted nipples look like with the Pinch Test:
- Pinch your areola on either side of your nipple.
- Notice what your nipple does when pinched.
- If it looks hollow or sucks inward, it’s inverted.
- Push your hand closer to your chest wall and pinch behind the nipple, trying to bring it out with pressure from behind.
- If your nipple won’t evert at all, breastfeeding might not work.
Breastfeeding with Inverted Nipples Tips
Sometimes breastfeeding with inverted nipples doesn’t work. Generally, women who have severely inverted nipples will also have a lot of pain while breastfeeding.
An inverted nipple is caused by strictures within your breast. Tough connective tissue pulls your nipple inward from the inside. When a baby latches on and sucks, it can hurt a lot.
But some women are able to breastfeed with inverted nipples with a few tips.
Try these things to breastfeed with inverted nipples:
- Work out the inverted nipple with your fingers.
- Try the Hoffman Method
- Try a sandwich hold and latching your baby to your breast.
- Use breast shells or nipple formers after 32 weeks of pregnancy.
- Don’t do this if high-risk pregnancy or at risk for preterm labor.
- Use a nipple shield.
- Try pumping before breastfeeding, or for an extended time.
The Hoffman Method to Treat Inverted Nipples
- Place your thumbs on either side of your nipple, over your areola.
- Gently press your thumbs towards your chest wall.
- While pressing towards your chest wall, pull your thumbs slightly apart.
The Hoffman Method can help to loosen the strictures in your breast that invert your nipple. Over time, your nipple can start to evert more and look flat or normal.
Try doing the Hoffman Method once per day, but don’t start until 32 weeks of pregnancy. Nipple stimulation can cause preterm labor, so if you are a high-risk pregnancy or at risk for preterm labor then avoid the Hoffman Method until after your baby is born.
Sometimes this method works to instantly evert nipples. If using this method everts your nipples, try doing it before breastfeeding your baby.
Use Breast Shells
Breast shells are made specially for women with flat or inverted nipples.
They work by pressing into your breast, allowing the nipple to protrude through a small hole in the middle.
Breast shells work by stretching the strictures within your breast and loosening them to allow your nipples to protrude. They can be worn underneath a bra to provide constant firm pressure to the area around your nipple, drawing it out.
Nipple formers work differently than breast shells. Instead of pressing on the breast around your nipple, nipple formers use suction to draw your nipple outward.
Sandwich Hold for Inverted Nipples
As mentioned above, a sandwich hold is a great option.
It helps your baby latch on to your breast by compressing the breast tissue for them to hold on to. You can squeeze your breast between your thumb and forefinger and even express a little milk so your baby knows where to latch.
A nipple shield may work if you have inverted nipples. The trick is to get the nipple shield as close to your skin, areola, and nipple as possible.
Turn the nipple shield inside out, placing it directly on your nipple and areola. Getting the nipple shield wet first may help.
Then, press the shield against your breast turning it right side out. Sometimes this works to draw your nipple or areola into it.
Latch your baby as deeply as possible, the nipple shield touching their palate may help them to start sucking and draw your nipple outward.
Pumping with Inverted Nipples
Some women with inverted nipples decide to exclusively pump. A supplemental nursing system could be helpful if you still want to try and breastfeed, and your baby has difficulty getting out milk.
Pumping for a short amount of time before a feeding may help draw out inverted nipples. The suction and pressure can stimulate your nipples to protrude. If you notice your nipple everting, try turning the pump off and latch your baby.
Additionally, some women notice that their inverted nipples get better with time. Moms that exclusively pump for an extended period of time can loosen the strictures causing nipple inversion. You may find that after a month of pumping, your nipples evert more and breastfeeding becomes easier.
Feed Your Baby
The most important thing to remember when trying to treat inverted nipples is to feed your baby! Try some of the techniques, but if they don’t work then it’s okay to either pump or give formula. The most important thing is to give your baby the nutrition they need.
Dealing with inverted nipples can be difficult, so reaching out for breastfeeding help may be necessary.
Inverted Or Flat Nipples During Pregnancy
Sometimes pregnancy naturally changes a woman’s nipples.
Women that previously had inverted or flat nipples may notice that they change and evert more after they become pregnant.
Additionally, some women notice their nipples change after pumping or breastfeeding their first child.
The female body goes through many hormonal changes that affect the breasts and breastfeeding. If you are newly pregnant, or not pregnant yet and worried about your nipples, give it time!
You may find that with all the breast changes you encounter during pregnancy, your nipples change and are perfect for your baby.
And not every woman has a hard time breastfeeding with flat or inverted nipples – it depends on you and your baby working together!
Breastfeeding with Inverted or Flat Nipples – To Sum it Up
Breastfeeding with flat of inverted nipples isn’t always easy, but it doesn’t have to be hard! There are just some different things you might need to try.
If you need extra help breastfeeding with flat or inverted nipples, I’m available for virtual consultations. Just fill out my contact form and I’ll be in touch with you!
Kealy Hawk, BSN, RN, CLC
Kealy is a Registered Nurse, Lactation Counselor, and most importantly a mommy! Her own baby feeding struggles gave her a passion to help moms throughout their feeding journey. She specializes in breastfeeding support and evidence-based formula recommendations. To talk with Kealy or take one of her breastfeeding or formula classes, visit https://littlebearcare.com.