Do I Have Flat or Inverted Nipples?

by Susie Hamilton
Breast Pumps Direct
Product Expert

Each and every woman has her own unique experience of pregnancy and birth. From the shape her body takes to the way it brings the baby into the world. The same is true for breastfeeding. Our breasts come in all sizes, with nipples that may or may not respond to your baby’s desperate provocation.

Some women have nipples that are flat or inverted. If your nipples prior to pregnancy do not extend much beyond the areola your nipples are flat. Most often flat nipples will protrude a bit more during pregnancy and nursing making it easier to breastfeed but if yours do not it does not mean you cannot breastfeed your baby. You may simply need to adjust your technique to help your baby latch on a bit easier in the beginning.

To find out if you have inverted nipples you can perform a simple “pinch” test on your breast yourself. Place your thumb and forefinger at the base of the nipple (about one inch behind it) and gently squeeze your areola. If your nipple dents inward as you squeeze it is considered inverted. This too does not mean that you won’t be able to breastfeed your baby. There are steps you can take to aid your nipples in protruding before and during your nursing period.


How can I make breastfeeding work with inverted or flat nipples?

The simple fact is that the early stages of breastfeeding are not easy for any mother and child whether you have perfectly taut nipples or nipples that shy away. It is generally the level of dedication a mother has to breastfeeding that will determine whether or not she will withstand the discomfort and frustration during those first four to six weeks with her newborn. In this way every nursing mother and baby start their journey the same, even if you have nursed five babies!

There are several ways you can attempt to make this transition and learning time for you and your baby a little easier, especially if you are working with flat or inverted nipples.


Proper Positioning

Preparing to breastfeed your child is not only about what your body naturally does but also about learning how your baby takes most comfortably to latching on. In order for a baby to properly latch on and stimulate milk production he must take a good portion of the areola into mouth as well as the nipple. This way there is adequate suction on the breast and the glands which supply the nursing mother’s milk. Placing you and your baby in the proper position prior to nursing can really make a big difference in the comfort level for you both.

A good place to start is to start by sitting up straight and nuzzling your baby’s tummy into yours. It will be much more comfortable for his head if you turn it for him and let it rest in a sideways position. Then, pinch your areola around the base of the nipple between your forefinger and middle finger cupping your breast. Gently coax your baby’s bottom lip down with your nipple to signal for him to open his mouth. Once he does and it is wide enough slowly place your breast into his mouth and nudge his head forward for proper positioning. If his tongue is not positioned under the nipple you will have to try again until it is. This may take a few times attempts or even days for the baby to understand as a feeding signal. Expressing a bit of colostrum (which eventually becomes milk) will help raise your newborns appetite to try and latch on as well.


Breast Shields

Breast shields, or also called breast shells or milk cups, can be used to help correct inverted nipples. They are a plastic ring and dome shaped aid that fits inside of your bra to help draw out your nipple by gentle suction. If your breasts remain flat or inverted after your seventh month of pregnancy you may want to start using these while still pregnant. You can discreetly wear the shields throughout the day until your baby is born but be careful to make sure no moisture becomes trapped between the plastic and your skin which could cause other problems, for this reason you should not wear the breast shields at night. It is also a good time to use them a little before nursing your baby to draw out your nipple for feeding.


Nipple Massage

There are several forms of massage that you can regularly practice on your breast to break up the binding tissues that cause nipple inversion. One technique is to press down on the sides of the areola until your nipple has no choice but to pop out. Then grab the nipple with your other hand and in an up-and-down and out motion gently pull and work in a circular motion. Do this 3-5 times each day to help stretch and loosen the nipple tissue.


Breast Pumps

A breast pump is a device that can easily become a nursing mother’s best friend. Not only do they help you express once your milk comes in but to a breast with inverted nipples they help erect the nipple for feeding. A breast pump will also simulate sucking which is the signal your body needs to begin producing and later, letting down your milk supply for baby. You can try while you are still pregnant by placing the suction cup on your breast and at a very slow and gentle pace allow suction for approximately 15-30 minutes about once or twice a day. If the suction is too strong or too long it could stimulate contractions so be sure to stop if you notice any abdominal pain and you should not start this until your last month of pregnancy and only if your a not a high risk pregnancy situation. After delivery you can immediately begin pumping which will draw out your nipple, stimulate milk flow and uterine contractions needed to bring it back to its pre-pregnancy size. If you plan to get a pump anyway, this is your best way to go if you have nipples that need a little help to come out. A woman who is not pregnant that has flat or inverted nipples can benefit from using a breast pump occasionally for nipple erection as well. Additionally, the Avent Niplette can be used by pregnant women during the first and second trimesters as well as non-pregnant women to permanently expand their nipple tissue.

Breastfeeding success is dependent on many factors and nipple shape is just one of them. The way your breast looks will not affect the milk quantity and quality produced by your milk glands. Ultimately, if it comes down to it, nursing a baby on one breast is possible and very feasible because in the end it is all about supply and demand. Just remember, start early and nurse often so you and your baby can get to a good start and start bonding in this beautiful and irreplaceable way!