Know It All: Breastfeeding With Inverted Or Flat Nipples

If you haven’t paid much attention to your nipples before, it’s not a bad idea to take a closer look if you’re planning to breastfeed soon. Many women who have flat or inverted nipples are often concerned about how this will affect their ability to feed their baby. The good news is that it doesn’t really have to cause any difficulty. With these few tips and tricks, you’ll have no trouble feeding your baby.

How To Tell If You Have Flat Or Inverted Nipples

There are different types of inverted nipples.


There are different kinds of inverted or flat nipples.

  • Dimpled: Only one part of the nipple protrudes. When pinched it protrudes fully but does not stay that way.
  • Unilateral: Only one of the breasts has a flat or inverted nipple.
  • Inverted: The nipple retracts inwards. Different women have different degrees of inversion.

A simple “pinch test” will show you whether your nipple is inverted. Use your thumb and index finger, to gently squeeze the areola about 1 inch behind the nipple. This technique will make a normal nipple protrude. If the nipple is flat, it will not show a difference. A dimpled nipple will only partially protrude. An inverted nipple will retract inwards.1


Can It Be A Problem For Breastfeeding?

Flat or inverted nipples can be difficult to latch on.

Most often, inverted nipples do not really pose a problem with breastfeeding as long as the baby is able to get a good latch.2 A good latch refers to the manner in which the baby has fastened to the breast. It helps reduce any pain for the mother and baby is able to get enough milk without having to use too much effort. A premature or weak baby may have some trouble since their suck would not be strong enough. If the degree of inversion is severe it can become challenging. But, before you give up, do consult a lactation expert before you decide to wean your baby. You may just need some specific techniques to help you find the right position and get a good latch.


How To Make Things Easier For Your Baby

Flat or inverted nipples are often caused because the tissues at the base of the nipple are still attached to the inside of the breast. These specific techniques and products are designed to loosen that adhesion and eventually correct the problem for the purpose of breastfeeding.

Simple Techniques You Could Follow

These methods don’t need any special equipment.


1. Give It Time

Often inverted or flat nipples will correct themselves through course of the pregnancy. By the time you give birth, the nipple may have become erect and easy to latch on to.

2. Hoffman Technique

Place both your thumbs on the areola on either side of the nipple at its base. Stretch the base by pulling your thumbs apart. Do this both up and down and sideways. This helps stretch the adhesive tissues. You can do this up to 5 times a day, close to or after birth. There is not much research to prove this works, but a lot of women seem to experience a difference. If you’re prone to premature labor, do not use this technique while you are pregnant as it may induce labor.


3. Pinch And Pull Back Technique

This technique simply makes use of your hands to help your baby get a good latch. Ideally, a good part of the areola and the breast should also be in the infant’s mouth while feeding. This is what helps trigger the sucking response. To help this happen, place your thumb and forefinger about 3-5cm behind the areola, squeeze and pull back the breast tissue towards your chest. This helps the nipple protrude. Allow the baby to latch on and only let go once your infant has got proper suction.

4. Use The Cold

If you can grasp it, roll the nipple between your thumb and forefinger. Then immediately use a moist paper towel or an ice cube wrapped in tissue to help the nipple become erect. Don’t use the ice for too long as it may become difficult to get the milk flowing when it’s excessively cold.


Products You Can Use

Breast pumps may correct flat or inverted nipples

These are products that can help you along the process of breastfeeding. You can buy them yourself or ask your hospital for supplies.


1. Nipple Puller

You can buy these specially designed products or make one at home yourself. They are essentially syringes with the end taken off. Using the suction helps pull out the nipple.3 You can do this regularly or just before a feeding. Try not to do it too often as it may result in the delicate skin cracking even before you start feeding.

2. Breast Pumps

Breast pumps serve the same function as the nipple puller. The suction helps draw out the nipple. You can briefly use an effective breast pump just before feeding.

3. Breast Shells

Breast shells are hard plastic domes worn under bras to draw out the nipple with gentle painless pressure. You can use them before the baby’s birth or between feedings. However, using them for extended periods of time may result in blocked ducts so be careful with their use.

4. Nipple Shields

Nipple shields are silicone or rubber teats that go over your nipple. It gives the baby something to latch on to but the problem is that it may reduce your milk supply due to lack of direct stimulation.

Remedies For Sore, Cracked Nipples

With all of these techniques and products pulling at your nipples combined with actual feeding times, be prepared to experience a lot of soreness and cracking. You can help them heal properly with the right remedies.

1. Breast Milk

Breast milk can heal cracked nipples

The easiest most convenient remedy is right at your disposal! Studies show that breast milk can help heal cracked nipples and reduce pain.4 After feeding spread a little bit of breast milk over the nipple just after feeding to help heal them.

2. Lanolin

Lanolin is a popular remedy for cracked nipples.

Lanolin is a waxy substance that is left on wool-producing animals. It’s obtained from domestic sheep most often. It sounds strange but it can be extremely effective on dry and cracked skin, anywhere on the body. Researchers have found that it’s an effective remedy for breastfeeding women.5 When using it on your nipples, remember that traces of this may enter your baby so use only 100% organic lanolin on your breasts.

3. Teabags

Teabags help heal cracked nipples

Studies show that women who used teabags for cracked nipples showed a significant drop in pain levels and experienced relief.6 Dip tea bags in slightly hot water and apply it on the nipple to ease the pain. After application of tea bags, wash the nipples with warm water to remove traces of tannic acid.

4. Peppermint Water

Peppermint water helps relieve cracked and painful nipples.

This is a popular folk remedy from the middle east that is now backed by research as an effective form of treatment.7 Add a few drops of peppermint oil to an ounce of water and spread over the nipples. Do this only after a feeding and make sure to rinse off before the next.

General Tips To Keep In Mind

Calm the baby if he is distressed by feeding.

  • Make sure to breastfeed early and often. This probably means about every 2-3 hours.
  • If your baby starts to get distressed, don’t continue to try feeding. Rock him, take him on a walk, and swaddle him until he calms down before trying again.
  • If you must supplement the feeding, do it with an eye dropper or other feeding tools like spoons. Artificial teats can make things confusing for the baby and even harder for him or her to get a good latch on your actual breasts.

If you’re worried about your ability to breastfeed, don’t be discouraged. There are plenty of techniques and products you can try. If you are struggling with breastfeeding, make sure to consult your doctor, and a lactation expert if possible.