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Breastfeeding with flat or inverted nipples
Before your baby is born:
What are flat or inverted nipples?
How to tell if your nipples are flat or
inverted.
How to prepare for breastfeeding with flat or
inverted nipples.
After your baby is born:
How to breastfeed with flat or inverted
nipples.
What are flat or inverted nipples, and how can
you tell if you have them? (back to the
top)
- Most women have nipples that stand out from the areola. Some,
however, have nipples that don't stand out, or even go in. These
are flat or inverted nipples.
- Even if you have flat or inverted nipples, you might have no
trouble breastfeeding. There is a simple test you can use to check
this.
Checking for inverted or flat nipples:
(back to the top)
- Do not perform this test before the third trimester (6 months
to the end) of pregnancy. Up to 35% of women may have flat or
inverted nipples before pregnancy. But great breast changes take
place during pregnancy in preparation for breastfeeding. Your
breasts enlarge as they develop milk glands. Your areola darkens
and enlarges; some people think this darkened areola serves as a
visual target for the nursing baby. Your flat or inverted nipples
may start protruding. If they do, you'll have nothing to worry
about.
- During your third trimester, check your nipples. If you have
nipples that are flat or inverted, do the following:
- See if they remain flat or inverted when stimulated. Put
some cool water on them (not ice; you don't need to torture
yourself!). Tickle them a little bit. If you happen to have a
breastpump around, pump for a few seconds. If you don't have a
breastpump, you can ask your mate to help. If your nipples
protrude as a result of this and remain protruded for some
time, then you'll have nothing to worry about.
- Put your thumb and finger on the areola just a little
behind the nipple. Squeeze gently. If this causes your nipple
to protrude, you have nothing to worry about.
- If your nipple remains flat or becomes even more inverted
when you squeeze the areola, then you should start preparing
them for breastfeeding.
How to prepare flat or inverted nipples for
breastfeeding: (back to the top)
- Start these exercises during the third trimester of
pregnancy.
- Wear breast shells. Follow the manufacturer's recommendations.
- You might need to wear a larger bra to accommodate the
nipple shield. If so, buy a couple of nursing
bras. Your breasts will enlarge even further during the
early stages of breastfeeding, so you'll probably need those
larger bras anyway.
- There are also some other exercises that you can do. Stop
doing them, however, if they hurt or discomfort you. You don't
want to damage the sensitive breast tissue.
- Gently pull and roll your nipple between your thumb and
finger. You can do this for several minutes a day. If it hurts
or is uncomfortable, don't do it!
- Put your thumb and finger on the areola behind the nipple.
Push slightly in towards your ribcage. Slowly slide your thumb
and finger out to the edge of the areola. You can do this for
several minutes a day. If it hurts or is uncomfortable, don't
do it!
After your baby is born: (back
to the top)
- Latching on might be more difficult
than with protruding nipples. Usually, however, there is no real
problem.
- You should be especially strict about avoiding
bottles and pacifiers if you have flat or inverted nipples.
Bottles and pacifiers can cause nipple
confusion in any baby. The risk is especially high if you have
flat or inverted nipples.
- See if your baby manages to latch on
correctly. If your baby is showing signs of feeding
well, and you don't experience sore
nipples or persistent breast engorgement,
everything is fine.
- If your baby is having difficulty latching
on, or you have sore nipples, then
you might need to prime your nipples before nursing each time:
- You can wear your breast shells for a few minutes before
nursing, and remove them just before attaching
your baby.
- You can pump with a breastpump for a few seconds just
before nursing your baby. Stop just as the milk starts to come
out.
- You can use your nipple tickling and rolling exercises for
a few seconds before nursing.
- All these exercises help the baby latch
on by making the nipple stand out.
- IMPORTANT: do not use nipple shields while nursing your
baby. Some older books may recommend these. However, they are best
avoided as they cause the baby to latch
on incorrectly. This may lead to sore
(or even cracked and bleeding) nipples, severe breast engorgement
or mastitis in the short run and
insufficient milk in the long run.
Don't use them!
- If you seem to have serious or persistent problem, call a
certified lactation consultant. It
costs a little money, but it's definitely worth it. Just one visit
from a lactation consultant can make the difference between a
miserable and a delightful breastfeeding experience.
- If your baby is not latching on
properly, watch out for insufficient weight gain. This need
not stop you from breastfeeding if you take a few precautions
while you tide over the difficult period. See the page on
maintaining or increasing your milk
supply for more information on this.
Go to:
The breastfeeding page
home
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