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Breastfeeding with pierced, flat or inverted nipples

The shape and size of the nipples in different women can vary greatly. Our practical tips will help you facilitate breastfeeding, no matter what your nipples are.
In most women, the nipples protrude forward, enlarge and swell from touch, but for some, the nipples are flat or even pulled inward. In addition, some women pierce one or both of the nipples. Usually flat, inverted or punctured nipples do not cause problems with breastfeeding, but in some cases additional help is needed.

“Do not panic if you have flat or inverted nipples. As a rule, this doesn’t interfere with breastfeeding, says Soned Hilton, a breastfeeding consultant, foster mother and baby care specialist who has been working with Medela in the UK for more than a decade. “Remember that your baby grasps not only the nipple, but also part of the chest.”

However, in the early days, when the baby’s mouth is still very small, and sucking skills have not formed, inverted or flat nipples can make feeding difficult, especially if the baby is unwell or prematurely born.

“Flat or inverted nipples may not reach the baby’s palate and, therefore, may not cause a sucking reflex,” Shoned explains. “That is, the child may have problems grabbing and holding the chest in his mouth, and the child will not receive enough milk.”

How to understand that you have flat or inverted nipples
Flat nipples1 do not protrude much above the areola (darker
the area surrounding the nipple), even when stimulated.

The inverted nipples are as if recessed inward in the center. They can look like this all the time or only if they are stimulated. Sometimes inverted nipples are on par with the areola, and sometimes they even sink deep into the breast tissue.

This feature can be observed on one or both nipples. An estimated 10% of primiparous women have at least one nipple retracted. 2 If you are not sure what your nipples are, try a simple pinch test: gently squeeze your chest with your thumb and forefinger on both sides of the areola. The nipple should come forward. If your nipple hides inward, creating a depression, then it is retracted.
Preparation of inverted and flat nipples during pregnancy
You probably noticed that during your pregnancy your breasts have changed and your nipples are more prominent. If this does not happen and you are concerned that the shape of your nipples will make it difficult to breast-feed, try using the nipple shapers * in agreement with your supervisor. These are soft and flexible silicone discs that are discreetly placed in a bra and gently squeeze the nipples, helping to pull them out.

“In normal pregnancy, nipple shapers can begin to be worn from 32 weeks,” Shoned advises. – Start wearing them one hour a day, gradually increasing the time to eight hours. If you have a weak (weakened) cervix or there is a risk of premature birth, consult your doctor about when you can start using shapers, since stimulation of the nipples can provoke contractions. ”

“Nipple shapers can continue to be worn after childbirth,” adds Shoned. “Try to put them in a bra 30-60 minutes before you start feeding.”

“I have inverted nipples, and after two or three weeks of constant attempts to apply to my chest, I almost switched to a mixture,” recalls Nina, a mother from Germany. “I went to La Leche Liga for help, and one nice woman came to me and supported me to continue feeding. She advised trying nipple shapers, and they really helped me. Somehow, my baby began to understand what needs to be done! “Breastfeeding went well, and I fed him until 21 months.”

How to help your baby grab flat or inverted nipples
If a child is happy to suck your finger, but his chest is not so interesting, there is a chance that your nipple does not reach him to the sky. The baby may be nervous, push away the chest and cry or even fall asleep on your chest. If this happens, ask a breastfeeding consultant or health care professional to check the seizure.

There are several techniques that you can use before each feeding to give your nipples a more comfortable grip shape. Shoned recommends the following:

twist the nipple between the thumb and forefinger so that it protrudes better outward;
place your fingers in the shape of the letter “V” or “C” and squeeze the chest immediately behind the areola to push out the nipple;
attach a cold compress or ice cube to the nipple so that it comes forward;
Express the milk manually or with a breast pump for a couple of minutes before feeding, so that the nipple protrudes more.
“I had one nipple flat, but I only found out when I noticed that it was difficult for Austin to suck on this side,” says Jennifer, the mother of two children from the UK. – From the anatomical point of view, there is nothing abnormal in this.

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