Breastfeeding can feel like a daunting task, even before you give birth. There seem to be so many variables that could potentially determine if you'll be able to nurse for as long as you'd planned. And, of course, you've probably heard more than a few stories about parents struggling in the breastfeeding department. So if you're preparing to do something as incredible as feeding another human being with your body, and you're wondering, "Is inverted nipple breastfeeding possible?" know that there's an answer and all hope is not lost.
“Breasts go through [a] stage of development during pregnancy,” Jacqueline Kincer, IBCLC, CSOM, a lactation consultant and breastfeeding expert, tells Romper. “Sometimes if the nipples are dimpled, flat, or only slightly everted, they will become more everted leading up to birth.” In other words, if your nipples are inverted and you haven’t given birth yet, remember that they will probably change during pregnancy to accommodate nursing later on down the road. In that case, you’ll be able to breastfeed with no issues.
And if your nipples don’t change during pregnancy — Kincer says they don’t always — don’t be discouraged. “Most of the time, proper suckling of the baby or using a breast pump can help to evert the inverted nipples.” That’s good news. Even for the fully inverted nipple, breastfeeding is entirely possible, although it does come with its own set of challenges.
What Are Inverted Nipples?
Look at your nipples. Are they flat or flush with your areola? Do they point inward toward the breast tissue? These would be considered inverted nipples.
If you’re still unsure whether you have inverted nipples, there is a simple test you can do to help you determine the state of your nipples and how they may impact your breastfeeding experience. “If you gently pinch the base of your areola, the nipple should move outward,” board-certified OB/GYN Dr. Kameelah Phillips, M.D. tells Romper. “If it does not, then it is likely inverted.”
Fully inverted nipples won't become erect if exposed to cold, so that's another pretty good hint as to whether or not you’ll face the potential complication of inverted nipples once you start your nursing journey.
How To Breastfeed With Inverted Nipples
First, Phillips reminds breastfeeding parents (or planning-to-breastfeed parents) that nipples aren't the end-all-be-all when it comes to breastfeeding, “‘Infants breastfeed, not nipple feed,” she says. “This is a very common saying in the lactation community.” In other words, don’t let your nipple situation hold too much weight over your breastfeeding confidence.
According to Kincer, the nipple is simply the “exit point” for the milk, meaning inverted nipples don’t normally interfere with breastfeeding. “The only other purpose the nipple serves is to touch the baby’s palate and stimulate their suck reflex, but the breast tissue can be shaped with the hand and a special latch technique can be used to get the baby to suckle without the nipple being everted.”
“To comfortably nurse, you should aim to have the baby open [their] mouth wide enough to wrap the lips about the areola and not the nipple,” says Phillips. “You can nurse with inverted nipples because the focus should be to put the [baby’s] mouth beyond a nipple and around the areola.”
However, just because inverted nipple breastfeeding is possible doesn't mean it’s easy. Phillips goes on to explain, pointing out that inverted nipples can make it more difficult to breastfeed: “One primary challenge is getting the nipple ready for breastfeeding. This is based on how inverted the nipple(s) are … It is not too common that inverted nipples obstruct milk flow, but milk can get trapped in the skin folds, so it is important to make sure it gets cleaned out.”
To prep the nipple for breastfeeding, Phillips suggests trying various methods of stimulation to move it to an outward position. “Hand expression, pumping, or stimulation with fingers or ice cubes can be used to help encourage the nipple to evert,” she tells Romper. “Pumping can especially help beforehand. Moderate suction will pull the nipple out and encourage droplets of milk to coat the nipple, which will attract the breastfeeding baby.”
Although these techniques will make inverted nipple breastfeeding easier, Phillips still highly encourages seeing a lactation consultant prior to giving birth. “This will help you develop strategies to troubleshoot issues before the baby arrives,” she says.
Speaking of things you can do before giving birth, Kincer suggests getting to work with things like breast shells, pumps, and massage techniques in the months before delivery. “After birth, it’s sometimes necessary to use things like a nipple shield, the reverse pressure softening technique, and pumping before latching,” she says. “These will all help inverted nipples start to evert, making latching less painful and easier.”
When To Consider Supplementing Formula
If you’ve exhausted all options and your baby is not meeting their nutritional needs with breast milk alone, you might consider supplementing with formula. Phillips says this decision should be made between parents and a pediatrician. “It is important to keep an infant fed and hydrated regardless if using breast milk, formula, or both,” she tells Romper. “They can make this decision based on hunger cues, wet and dirty diapers, and weight loss. Caregivers can give expressed (hand or pumped) breast milk first and then follow with formula.”
But the first line of intervention, according to Kincer, is to get proper lactation support. “If formula is needed while working through breast milk production issues, that will ensure the baby is well-fed in the meantime,” she says. That’s not to say you should quit breastfeeding while you try formula, but it is an indication that it might be time to find a lactation consultant if breastfeeding is the goal.
At the end of the day, the most important thing is that your little one is well-fed and healthy. Worst case scenario, your flat or inverted nipples will only pose a unique challenge in getting there, not a total roadblock.
Dr. Kameelah Phillips, M.D., board-certified OB/GYN and founder of Calla Women’s Health
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