Each and every body is so completely unique in such beautiful ways. No two people are exactly alike. Yet, many of us share some similarities. When we come across a trait that isn’t part of the publicized sense of “normal,” sometimes we are left feeling completely alone. Too many mamas with inverted nipples are worried that they are alone with this problem or that it means they are somehow broken and unable to breastfeed. In truth, inverted nipples or flat nipples are relatively common. Even better – you should be able to learn to breastfeed just fine.
Identifying Inverted Nipples
The terms flat nipples and inverted nipples refer to the way the nipple protrudes. Sometimes, this is visible all the time. In other cases, you don’t even know until you’re looking for it, such as when you first attempt to breastfeed.
To truly be inverted, the nipple will not protrude when the areola is gently squeezed. It might retract just slightly, to be flush with the areola, or even further inward. This is simply a matter of tight, slightly fused tissue beneath the areola and nipple. Both nipples might be inverted, or just one, or at different amounts of tension.
Nipples can be flat against the areola and still protrude when prompted. This isn’t what we refer to as a flat or inverted nipple and shouldn’t create any roadblocks when trying to nurse.
In fact, even flat nipples and inverted nipples can sometimes be drawn out with a good latch without any extra effort at all. It all depends on the tightness of the tissue and the severity of the inversion.
Not to worry – as La Leche League reminds us – we breastfeed, not nipplefeed.
Breastfeeding with Inverted Nipples
Inverted nipples don’t have to stop you from breastfeeding. Depending on the exaggeration of the inversion, you may not even notice a difference. Often, slight inversions are drawn out simply by having a good latch.
For more prominently inverted nipples, you’ll want to gently stretch and work the nipple and areola tissue to help release the tension that is pulling it inward. This can happen with several exercises or tools:
- Press your thumb and forefinger down at the base of the nipple and gently stretch the tissue outward. Don’t overwork the tissue – just a couple of times each day, especially if you catch it during pregnancy.
- Use a Latch Assist to gently pull your nipple out a little at a time through out pregnancy.
- Use a nipple shell in your bra, which presses onto the nipple to help stretch the tissue.
In all likelihood, you will not need a nipple shield, though that is often the first advice our well-meaning friends and family will give. Instead, directly breastfeeding with inverted nipples stretches the tissue. This is why pumping can be a useful tool but a nipple shield cannot. You want baby to latch well and pull that tissue loose.
Latching baby deeply can help them to pull milk in despite an uncooperative nipple complex. It can also help to draw the nipple out over time. Try rocking from the bottom lip onto the top, getting as much of the areola into the mouth as possible.
Until the nipple stretches out some, both baby and mama might get frustrated. It’s okay to let baby calm in other ways if she gets fussy, then try again when she’s been soothed. Remember that you are both learning each other. It’s okay to be patient – not rushed – through that process.
Reach out to an IBCLC certified lactation consultant, your care provider, or a La Leche League leader if you need help getting into the rhythm of latching and breastfeeding with inverted nipples.
Not only can baby get frustrated and mama need support, but breastfeeding with inverted nipples might be uncomfortable, as well. As the tissue pulls and stretches, or you inadvertently latch shallow or “chomped,” soreness is almost inevitable.
- Nipple Salve is formulated to be safe for baby so that mama can apply it to sore, cracked, tired nipples as needed.
- Cool compresses can be soothing for short amounts of time.
- Fresh air on nipples that are cracked or chafed will help heal faster than when cooped up under layers of clothing and breast pads.
What’s more, nipples that remain inverted without pressure might retain moisture, leading to more chafing and discomfort. Nipple Salve not only contains anti-inflammatory herbs but also forms a moisture and friction barrier that is meant to prevent that kind of damage.
Nipple inversion of some sort is relatively common. Your breastfeeding support people and your care provider will have helped other mamas overcome the obstacles, too. Even through inverted nipples, your love and milk can still flow.