It me. I am mother with inverted nipples.

Did I face struggles breastfeeding my child? Yes.

Did I want to give up? Yes.

Did I successfully breastfed my child? Yes, I did. Two years to be exact.

True story right there. Just like many of you reading this and experiencing the same struggles, before I give you tips, let’s understand our nipples a little better, shall we?

The Flat Or Inverted Nipple Guide

There’s a pretentious belief that the bigger breasts, the more milk it will produce. FALSE. The size of your breasts does not indicate this, darlings. I personally know a mother with a small cup and she produces more milk that I do. She’s a size A and I’m a size C! She was producing her liquid gold like magic (or so it seems to me) and there I was crying for more milk. So no mommas, please don’t fall trap to this myth but instead, be prepared.

Speaking of sizes, our breasts come in different shapes as well. This too, applies to our nipples. It is not bizarre for you to wonder whether there’s something “wrong” with your nipples, breast or even areolas when you start to face issues with breastfeeding. Fret not! I can assure you that breastfeeding with flat or inverted nipples is indeed possible and that babies by nature can latch on to any nipple – inverted or not.  

The Pinch Test

To know what sort of nipple you have, do a “pinch” test. Gently press your areola (the area around you nipple) and see if it erects. If it doesn’t, then that means you have a “flat” nipple. However, if it retracts (goes back) into your areola, then you have an inverted nipple. Though if your nipple does erect (poke out) then it’s an everted (normal) nipple.

Types Of Inverted Nipples:

Now, let’s learn the different types of flat or inverted nipples.

Dimpled

A dimpled nipple is when your nipple is partially protruding. A simpler understanding to this term is that it’s a short nipple. Some women just don’t have long nipples so even if you pull it out, it just won’t stay out. It’s neither out nor in.

Unilateral

This is when one breast faces the inverted or flat nipple issue.

Inverted

Explaining this may be a little complex. There are three grades to this description.

1. Grade 1 - ”Slight”: little to no problems with breastfeeding.
2. Grade 2 – “Moderate”: Manageable, yet may face issues with preemies or if your baby as a poor latch.
3. Grade 3 – “Severe” – You will need to consult your doctor or lactation nurse regarding this issues as your baby will face difficulty getting a good latch.

Is There A Way To Prepare My Nipples For Breastfeeding?

Sadly, no. The only form of preparation that you can do while you are pregnant is to equip yourself with as much knowledge as you can about postpartum and it’s challenges. It’s filled with a lot of gray areas that a lot of women still don’t discuss much about so read on that. Click here for one of them – Postpartum Hair Loss & 8 Treatments That Won't Break The Bank.

Hormones play a role in stimulating the nipples. So while you may find yourself with pert nipples during pregnancy, this may not be the case after childbirth as our hormonal imbalance will take effect.

6 Breastfeeding Tips For Flat Or Inverted Nipples

A common issue raised among mothers with flat or inverted nipples is their baby’s poor latch. Having flat or inverted nipples may cause problems, but that does not mean you are not able to breastfeed totally. These tips will help your breastfeeding journey and you can opt to use these tips individually or simultaneously to assist your baby.

1. Use A Section Device

This was my trick. Well at least, one of them. I used my breast pump to draw my nipple out and found that it somewhat worked. Not only did it pull my nipple out, but I also it also let it massage my breasts for a minute or two before I latched my daughter on to me.

Since the effect is only temporary, I suggest put baby at the breast as soon as possible if not right away. Check how outward your nipple is an indicator to begin the feeding session.

Here are other suction devices available:

• Nipple everter
• DIY syringe everter
• Hoffman technique

2. Stimulate The Nipple

An easy tip for all mothers which every lactation nurse will recommend, is to  stimulate your breasts and nipples first before a feed. This gentle stimulation of rolling and touching your nipples between your fingers can help protrude them.

Another sensation to stimulate your nipple is by making them cold. Apply a cold compress or cold face cloth to your breast can help you see results. Using ice is not recommended because this could lead to a slow milk let-down.

3. Breast Shells

This is a debatable area. There are articles which reported seeing not much difference in comparison to those who use and those who didn’t (Hediger & Koening, 2020).

If you do decide to use this technique, place the breast shell over your nipple approximately 30 minutes before your baby’s feed. Once you notice your nipple has protruded, put your baby close to your breast for most effective results.

4. Hand Express

I’ve tried doing this but I wasn’t very comfortable with hand expressing my milk out. Or rather I found it awkward as I felt I wasn’t doing it correctly.  

However, a lot of mothers found this tip beneficial because when they hand expressed a little milk into their baby’s mouth, they noticed that this had a calming effect on their baby. This not only triggers the suck reflex but it also gives them a little more patience as they try to get a good latch.

5. Push Your Areola Back

This is technique is called the ‘breastfeeding hold’. This is another easy way to help your nipple evert as when you push your areola back (thumb on top and three fingers on the bottom), it will assist baby to latch more properly.

6. Nipple Sheilds

It’s a small, thin plastic device which you place over your nipple. As your baby suckles, the plastic is pulled against its mouth where the nipple is fitted and positioned perfectly allowing it to suck more easily.  

From one mom to another, this was one of the first tip I learned of but was grateful I never tried. This is because using a nipple shield would usually mean having to wean your baby off of it. Although I may have one problem resolved, I knew I didn’t want my baby to be dependent on it for her feeds. Nipple shields may be a good short-term alternative, but I suggest only using it as a last resort.

Common Struggles With Flat Or Inverted Nipples

SORE NIPPLES

Naturally, you are definitely going to find yourself with some discomfort as whit inverted or flat nipples, baby will have to try extra harder to try and get a good latch. Don’t worry, over time, this pain and discomfort will ease as all that suckling will improve the inversion.

BREAST PREFERENCE

Babies will tend to latch on the breast that provides them the fastest milk let-down. Therefore, this creates a preference for the breast with the everted nipple. Your baby may also begin to reject the affected nipple. It is important for you to address this issue because in order to prevent engorgement or mastitis, you will need to keep on offering the rejected breast. If baby is still rejecting, express the milk through pumping.

SLOW WEIGHT GAIN

Although I had a good latch with my baby despite my inverted nipples, it was difficult for my baby to gain weight steadily. This could be due to lack of milk supply but for mothers who do have good milk supply, but you’re noticing your baby is losing weight or slowly gaining, check with your lactation nurse or doctor. Poor latching could lead to poor feeding sessions.  

I hope you find this guide helpful and informative. Knowing this advice in pregnancy can prepare you to avoid breastfeeding attachment problems. To the mamas who are facing this issue now, I understand how frustrating it can be but don’t worry, know that it is common and it is doable. Seek your lactation nurse if you’re feeling lost and need that extra help. Power to you, Mama!