Breastfeeding: Is nursing possible with inverted nipples?

I have flat or inverted nipples. I was told in the hospital to use a bottle nipple over my own to breastfeed my first son. This was after several attempts to breastfeed naturally. This was VERY discouraging to me. I felt like a failure. Is nursing really possible for me?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

I'm sorry to hear that you had such difficulty nursing your son. Breastfeeding is possible even with flat or inverted nipples. You might wonder how this is possible. Actually, your baby takes in your breast tissue and forms it into a nipple, easily accessing your milk. Often a nursing mother will find that her nipples do begin to evert and extend after she has breastfed for a while.

It is probably a good idea, starting in the last trimester of your pregnancy to wear breast shells throughout the day. These may help to draw out your nipples prior to your baby's birth.

As soon as possible after your baby is born, put her to your breast. It is very normal for her to lick and suck, and not attach fully and nurse at this time. Don't become discouraged. Nursing early and often, while avoiding the use of pacifiers and bottle nipples will help your baby adjust to your nipples, exactly as they are.

If your baby has problems attaching to your breast and staying latched-on, do not use a bottle nipple to cover your own nipple. It is very disappointing to hear that this practice is still being recommended in hospitals today. This is extremely dangerous. It can severely limit the amount of milk that your baby receives during a feed. Your breasts will also receive minimal stimulation through the bottle nipple. This will cause a decrease in your milk supply. Infant deaths and extreme dehydration have been reported with their use.

Don't be too quick over the first couple of days to jump in and intervene, using a nipple shield during a feed. Allow your baby lots of practice time at your breast. If she has a difficult time latching on, ask the hospital's Lactation Consultant to work with you in positioning and attachment, and if necessary express your colostrum and feed it to your baby in a syringe (at your breast, or by finger-feeding.) Be patient. Sometimes it just takes a few days for a baby (and mom) to get the hang of breastfeeding.

If it is decided that a nipple shield would indeed be helpful in your situation, you still need to be carefully followed when using the newer (and thinner) silicone nipple shield. It is important to carefully observe and keep track of your baby's daily output, and pattern of weight gain (with frequent weight checks) to be certain your milk supply isn't becoming compromised. Nipple shields are (generally) intended for short term use.

Work closely along with an IBCLC, who can follow you and your baby closely, as your baby is being transitioned to your breast. Very best wishes for a wonderful nursing relationship this next time around!

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