My Nipples Are Flat and I Want To Breastfeed - Any Advice?

How many times have I heard mothers say that they wouldn’t be able to breastfeed because they have flat or inverted nipples? Countless! Some mothers have even said that they were told that their nipples were flat (when attempting to breastfeed) when their nipples were not flat at all.

Humanity is so beautiful and diverse. Think about it, there are as many shapes of breasts as there are women on the planet, and they are all made for breastfeeding!

It’s true that some shapes can give more challenge than others with regard to babies latching; but I do believe that flat or inverted nipples have gotten a bad reputation when it comes to success for nursing mothers at feeding time.

So what are flat or inverted nipples?

Nipples definitely come in all shapes and sizes, not always pointing outward away from the breast. Some nipples protrude while others are flat and some are even inverted, pulling in towards the chest. Breast shape and size also changes in pregnancy and sometimes flat nipples push out during this time or in the first days/weeks after birth.

Reasons why flat or inverted nipples have a bad reputation:

• There are prevailing negatives connotations for having flat nipples if you’re a nursing mother. There’s often a belief that baby may never latch, or breastfeeding will be very difficult.

• These negative ideas are very much taken on by the mother and she then believes that she will not be able to breastfeed.

• These ideas then make it difficult for the mother to breastfeed, or imagine that it could work. She may be reluctant to seek help or support. This may manifest as a defeatist attitude towards her ability to breastfeed

• These issues can create inhibition and further challenges in addition to what is being experienced by the mother. This also doesn’t take into account any other challenges that are playing out in the mother and baby’s feeding relationship.

The remedies:

1. Many babies are actually able to latch onto the breast correctly and feed, even though flat or inverted nipples may make it difficult at first.

2. There are specific tools and techniques that mothers can learn to use once they commit themselves to breastfeeding despite flat or inverted nipples, e.g. nipple shields, breast shells, suction devices that draw out the nipple, breast pumps etc. alongside specialist support.

3. Suction devices like nipple extractors are designed to be worn under the clothing and work by pulling the nipple into a tiny cup. Eventually with regular use, these devices may help loosen nipple tissue, allowing it to protrude more.

4. Hand expression can help, especially if the breasts are engorged with milk, which makes the breast feel hard and makes the nipple flatten.

5. Try holding, handling and shaping the breasts to stimulate the nipples (gently rolling the nipple between thumb and finger). A more systematic approach involves the Hoffman technique (2017) which has been found to improve nipple type and quality of breastfeeding when used consistently.

6. Holding the breast in a C-hold or U-hold (with finger and thumb opposing each other from underneath or either side, respectively), is essential for a correct latch anyway, especially where the nipple is flat This helps you flatten the breast tissue for a better fit into baby’s mouth and gives you more control.

7. There are many other resources, lactation professionals and on-line forums out there to help mothers garner the knowledge, patience and determination necessary for success. Do your research!

8. Where natural techniques have been unsuccessful, surgery can be an option. There are 2 types; one preserves some of the milk ducts so breastfeeding is still possible, while the other type does not. Enquire with your doctor whether this could be an option for you.

Most mothers who have flat or inverted nipples, with commitment and determination, will achieve a successful latch and feeding. The use of techniques and tools to assist them on their journey is an essential part of the process. In Barbados, we are lucky enough to have an organisation that supports nursing mothers and focusses on creating a culture of breastfeeding on the Island. Contact the Breastfeeding & Child Nutrition Foundation (The BCNF) and get all the help and support you need. When the help is at hand-make best use of it!

 ABOUT THE AUTHOR

Andrea Bonita Jordan is a registered (freelance) Midwife, Breastfeeding Specialist. and co-founder of two charities: The Breastfeeding and Child Nutrition Foundation (The BCNF charity # 1169) and Better Birthing in Bim