Inverted Nipples or Flat Nipples can cause some extra challenges in establishing successful breastfeeding. Let me say first, that women with inverted nipples or flat nipples *can* establish and maintain successful and long-term breastfeeding relationships. And the best news is that the longer you nurse, the easier it will be with subsequent children, and nursing naturally draws out the nipple, allowing you to start off in a better place each time!
For a further exploration of how to know if you have inverted or flat nipples, why you need to know if you have inverted or flat nipples, and if those with flat or inverted nipples can "prepare" their breasts for nursing please see my article "Inverted Nipples and Flat Nipples" through the related links at the end of this article. For the purposes of this article, I'm writing about what to expect if you already know you have flat nipples or inverted nipples.
It's important to know that some babies may be such excellent nursers that they will latch right on and nurse successfully regardless of the shape of your nipples. However, if you know you have flat or inverted nipples, it's best to arrange to be in touch with lactation support, paid or volunteer, before your birth so that you have someone to call upon immediately if you need help – the first hours and days can be critical to getting nursing started off in the most natural and intervention-free way.
You can also do your best to have the most natural and intervention-free birth as possible, to enable your baby to be the most alert and focused on the task at hand. Birth interventions such as epidurals, pitocin, breaking water, etc. can affect the flow of your labor and lead to resulting problems that can interfere with the natural urge or ability of the baby to breastfeed. In my case, an epidural may have contributed to a faster than natural labor, causing the baby to expel meconium, leading to suctioning, leading to mouth trauma for the baby, leading to rejecting the breast. This is part of why I chose an unmedicated, homebirth for my second daughter and had very few issues. Non-emergency or elective c-sections or questionably necessary elective inductions, while they may seem convenient can also lead to increased breastfeeding difficulties – this is rarely discussed as one of the "cons" when weighing the potential for these procedures with doctors. If you have flat or inverted nipples, you may want to consider even more seriously a serious, planned attempt at a natural birth.
Know that nursing with flat or inverted nipples can lead to slightly more than normal nipple soreness. It is my understanding that flat or inverted nipples are usually caused by adhesions which never "opened" up naturally during puberty (little girls all have flat, or often inverted, nipples). As the nipples are pulled out by early nursing or pumping, there may be some discomfort, from mild to severe. However, it's important to remember, this is temporary – while nursing has lifetime rewards for mother and baby.
Taking a breastfeeding class before your birth will help prepare you for truly understanding how to help your baby achieve a successful, deep latch. The more you understand this, the less the nipple shape itself will matter and the less nipple soreness and discomfort you will experience.
Lastly, if your baby is just not latching on, there are excellent interventions like nipple shields that, ideally under the guidance of trained lactation support, can be used temporarily or less commonly, for the duration of nursing. Nipple shields can compensate for flat or inverted nipples until your baby becomes a more confident nurser and nipple shape becomes a non-factor in success. See my series of articles on Nursing with Nipple Shields, Weaning from Nipple Shields and Nipple Shields – My Experience accessible through related links below.
If you have questions about Flat or Inverted Nipples or how to breastfeed successfully while facing this *very* surmountable challenge, please make a post in the BellaOnline Breastfeeding Forum .
Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor a Certified Lactation Consultant. If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.