Breast-milk is the complete food for your baby. Feeding your baby will be the most anticipated moment of your life. Studies have shown that breast feeding has an important role in creating a special bond between mother and child. But sometimes a baby finds it difficult for latch on to your breast. Now is the time to examine your nipple. There are chances that you have a flat or inverted nipple. Just like breasts come in all shapes and sizes, nipples too can vary in shape. Mostly nipples are projected out which makes it easy for the baby to grasp. But when some variation in shape, size, or texture happens to the nipple, breastfeeding can be difficult.
Breastfeeding mom
But don’t worry. A little patience, more attention, and a good posture can solve your problem. And also extend of the inversion is found to decrease with successive pregnancies.

What Are Flat Or Inverted Nipples?

The flat or inverted nipples are formed due to the adhesions, which ought to be opened up naturally during puberty doesn’t open. Adhesions bind the skin to underlying tissue, at the bottom of the nipple. These adhesions generally open up during pregnancy, when the skin becomes more elastic, especially during the third trimester. However, some times, some cells stay attached to the base, which may require some effort from your side. Also, some degree of inversion in nipples may be noticed by some moms in early pregnancy, but most of these nipples protrude once the skin becomes more elastic during the third trimester. Only 10% of pregnant women will have flat or inverted nipples by the time their baby is born.

How Can I Know That My Nipple Is Flat Or Inverted?

Finding out the shape of your nipple by merely looking at your breast often won’t work as the nipple may appear normal to you. You can do a ‘pinch test’ to determine the shape of your nipple.

How To Do Pinch Test:

Gently press your areola almost an inch behind the nipple with your thumb and index finger.

  • Now, if your nipple does not become erect then you can be certain that your nipple is flat. The flat nipple will not project when gets stimulated
  • During your pinch test, if your nipple is drawn back or become concave then you can say your nipple is inverted. The inverted nipple will pull inwards when stimulated

Most of the times, flat or inverted nipples won’t be an issue during feeding your baby if your baby is able to latch on areola instead of the nipple. As the breasts are independent of each other, in some mothers only one nipple will be inverted or flat and the other nipple will be normal (unilateral). Just as one breast produces more milk than the other.

How Difficult Is It To Nurse A Baby With Flat Or Inverted Nipples?

The difficulty of feeding depends up on the degree of inversion and obviously how strong and vigorous feeder your child is. The degree of inversion is determined by how deeply it retracts below the surrounding areola. When the degree of inversion is mild the baby can suck the breast without any issue, provided he can suckle normally. But an immature baby may not be able to suckle easily at first as preemies are weak in suckling.
Feeding your baby with moderately or severely inverted nipple can be an issue.
If your inverted nipple belongs to folded or dimpled category in which only part of the nipple is inverted, then you can pull it out with your hands. Even if it won’t stay pulled out, it will help your baby to latch properly.
Flat or inverted nipples

How Can Flat Or Inverted Nipples Be Treated?

It is better to do the pinch test much earlier during your third trimester, especially near delivery. This will help to get ample time to try pulling out the nipple before the baby is ready to suckle. Below we suggest some methods and techniques to make the feeding easier if you have an inverted or flattened nipple. Some of them can be practice during your pregnancy time and other only after the needy one comes.

  1. Hoffman’s techniques: This is a manual exercise which can be done during your pregnancy to prepare your nipple for your child. Don’t worry if you skipped that phase. You can also do it after the delivery to make the suckling easier for your baby.If your nipple is inverted due to the adhesion in the base of the nipples this technique can be tried as this procedure will help to loosen the adhesion.
    You should place your thump directly at each side of the base of the nipple. Now push it firmly against your breast tissue. At the same time, you should also pull your thumbs away from each other. This procedure will aid in loosening the tightening at the base of the nipple and stretching out the nipple.
    Repeat this procedure at least 3 to five times a day. While repeating remember the thumbs to move in a clock wise direction
  2. Using nipple formers: As the name indicates these shells worn inside your bra, helps to form the nipples by drawing the nipple out. This is also known by other names such as breast shells, milk cups or breast cups. Breast shells come in two pieces, base, and a dome, and made up of plastic. The inner peace has a hole which holds the nipple.
    They apply a gentle but constant pressure on areola gradually breaking the adhesion of the skin. You can wear it during the third trimester for a few hours every day and the time can be increased according to your comfort level. Or you can make it a routine wearing it thirty minutes prior to each feeding. Remember not to use it during the night and not to use the milk collected in them. Also, remember to wear a bra one size larger to contain the shell
  3. Nipple stimulation: Just before feeding, if it is possible for you to grasp the nipple, just roll it between the thumb and index finger for a couple of minutes. Immediately touch it with an ice cube wrapped in a piece of cloth for around 10 seconds. This will help the nipple to stay erect till the baby grasps it
  4. Breast pump: Using a breast pump immediately before feeding, is found to help in drawing out of the nipple in some cases. If it works, do it regularly till the adhesion under the nipple is completely wiped off
  5. Nipple enhancer: The Evert – It nipple enhancer is a medical device designed by lactation consultants to help the mothers with inverted or flat nipple. It is a syringe with a soft flexible silicon end used to suck the nipple out when the other end is pulled out like a vacuum pump. You can use it prior to every feeding
  6. Latch assist nipple everter: Lansinoh latch assists nipple everter is a product that you can buy online. This tool helps the nipple to temporarily stand out. It consists of a nipple everter bulb and two flanges. The bulb is joined to the suitable flange and the flange is positioned correctly over the areola with the nipple in the center. Now gently press the bulb in very short intervals. The nipple will gradually come out as the suction progresses. Once it is out your baby can be able to latch on it easily
  7. Bread sandwich method: In this method, you should grasp your breast well back on areola with the thumb on the top and fingers below. Now push in and push out towards your chest. This will help to elongate the areola and your baby could easily latch on it
  8. Frequent feeding: Feeding your child frequently will help to avoid engorgement which will make the nipple harder to grip.
  9. Loop your partner in: Your spouse will be happy and enjoy stimulating your nipples, making your nipples protrude for breastfeeding. This exercise will also provide much needed physical contact to you and your partner
  10. Using the nipple shield: Consider this as a last option. When all the above technique fails and still your child show difficulty to latch then trying a nipple shield can be a solution even though it is said to decrease the milk supply

Once your baby starts to suckle properly you should minimize the usage of latch assists and promote natural feeding. Once the nipple everts consistently, it will rarely invert again. Plus, the younger babies will not have any concern with breastfeeding since the older sibling has already pulled the nipple out.
We wish you a happy feeding time.