Updated – Jan/2021
Nipples come in all shapes and sizes. Worried about whether your flat nipples will be okay for breastfeeding. Learn about these 12 tips to make breastfeeding with flat nipples little easier.
No matter how much prepared you feel for your breastfeeding journey, many women struggle to breastfeed their babies.
Although most women are able to breastfeed their babies regardless of nipple shape and size, certain cases require more work than others.
Among the common breastfeeding problems of why your little one is struggling with breastfeeding could be “flat nipples”, making it challenging for the baby to get a firm grasp. This may result in the baby not getting enough milk because of the baby’s poor latch on. Consequently, decrease in milk production, and in turn, the baby loses interest at the breast.
Worry not, mama! The good news is that with a little extra care and patience, mamas with flat nipples can also breastfeed just fine.
Here’s what you need to know.
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What are Flat Nipples?
Flat nipples do not stick outward. They are not distinct from the areola and the surrounding skin on your breast. Even when they are exposed to cold temperature or stimulation, flat nipples neither stick outward nor turn inward.
Nipples that appear flat most of the time but stick outward when exposed to cold or stimulation are NOT true flat nipples. Some women have nipples that remain flat most of the time, but they often start to stick out during pregnancy.
You may also notice flat nipples when breasts are engorged. Overfilling with breast milk can make your breast swollen and hard, making it hard for the baby to latch on.
Flat nipples do not interfere with breastfeeding most of the time as long as babies take a good portion of the breast into their mouth. However, if the baby is premature, weak, or having latching difficulty, flat nipples can be especially challenging.
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How do I know I have a Flat Nipples?
You can access your nipples to check if you have flat nipples. There are two simple ways to tell if you have flat nipples or not.
Nipple Pinch Test
- Place your thumb and forefinger on the edge of the areola (one inch back from nipple).
- Compress and thumb and forefinger it lightly.
- Do this test on both breasts.
- If the nipple protrudes out, you have normal nipples.
- If the nipple does not protrude outwards after compression, then you have a flat nipple.
- If your nipple retracts or become concave when compressed, then you have inverted nipple.
Stimulate your Nipples
You can stimulate your nipples with an ice pack or cold moist cloth. If your nipple does not stick out, then you have a flat nipple.
If you are still not sure, you can consult your health care practitioner. They will do a quick exam of your nipples and let you know if you have a flat nipple or inverted nipple. Regardless of your nipple shape, it does not affect your breast milk production or your ability to dispense it.
If you think your nipples are flat during pregnancy, hormonal changes after the birth of your baby may cause them to protrude naturally. So you should take this test during pregnancy and after your baby arrives to check the status of your nipple.
Why are my Nipples so Flat?
The breast is composed of glandular (lobes) and adipose tissue held together by a loose framework of fibers (1). The amount of fatty tissue in your breast and the length of milk ducts determines whether your nipples are flat, normal, or inverted.
Flat nipples are fairly common among women. The flat appearance of nipples changes when you become pregnant when skin elasticity changes. Breastfeeding also causes the flat nipple to protrude naturally as a baby latch on the areolas and draws the nipple out.
There are many causes why your nipple lie flat (2),
- It may be the result of the milk duct (lactiferous ducts) not being grown properly.
- Abnormally large extra fat tissue causing nipples to retract into them.
- It could be hereditary
However, having a flat nipple is normal, it is always advisable to consult with your family physician to know the cause of flat nipples and rule out any underline medical condition.
Here are 12 tips and tricks to keep in mind if you’re breastfeeding with flat nipples and it will help your flat nipple stick out for breastfeeding.
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12 Tips for Breastfeeding with Flat Nipples
1. Getting a Deep Latch
Wondering, how do I feed my baby with flat nipples? The simple answer is getting a deep latch!! If the baby latches deeply onto the nipple, areola, and breast tissue, flat nipples are not a problem for breastfeeding.
Regardless of the shape of your nipple, a shallow latch create many breastfeeding issues such as lipstick nipple, clogged milk ducts, and even a decrease in milk supply.
To ensure a good latch, hold the baby close and align the baby’s nose with your nipple. Bring out the nipple by pulling your breast tissue back, rub baby’s lips with your nipple, when your baby’s mouth is wide open, hug your breast onto the baby’s mouth.
2. Breastfeeding Hold
Trying different breastfeeding positions can make it easier for your baby to latch on. Use V-hold or C-hold position to hold your breast and offer areola and nipple to your baby.
Make a V or C shape by compressing your breast with fingers a few centimeters behind your nipple. These holds help support your breast and help the baby to latch deeper onto your breast tissue and feed well.
Some moms swear by laid-back breastfeeding when they have flat or inverted nipples as gravity takes over and overturns the pull of breast tissue so the baby can take the breast easier and deeper.
3. Breastfeed Early and Often
If possible, nurse your baby as soon as possible after delivery and often after that along with skin-to-skin contact. Breastfeeding in the first few days is very important for a good breastfeeding relationship.
Often feeding soon after delivery will help your baby get comfortable with breast before your milk comes in. Once your milk comes in (3-4 days), the breast gets firmer and this can make it harder for the baby to latch on with a flat or inverted nipple.
4. Getting Help
Among the most common mistakes that a mom makes during breastfeeding is not getting help when needed. When you are dealing with a flat or inverted nipple, it is important to make sure that baby is latching on correctly.
If you are having trouble getting your baby to latch on, ask for a lactation consultant to evaluate the baby’s latch. They will recommend the best way to deal with your specific condition.
If you can not get an appointment to see your lactation consultant in person due to COVID 19, you can learn how to latch on your baby from the comfort of your home by taking The Ultimate Breastfeeding class by Stacey, a board-certified lactation educator.
This online class goes into detail about latching and positioning, expressing and pumping, common breastfeeding challenges, and much more.
It is not too late to take this class. I took this class 2 weeks after my baby was born and it helped me tremendously to deal with breastfeeding challenges.
Read my full review of The Ultimate Breastfeeding class here.
5. Keep a Track
If you are breastfeeding with flat nipples, keep a tract of baby’s wet diapers to ensure he/she is getting enough milk. Also, make sure the baby is gaining age-recommended weight.
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Here are the ways to stick out flat nipples manually (6-8)
6. Reverse Pressure Softening
To make flat nipples stick out for breastfeeding, use your fingertips to encircle the base of the nipple and push inward toward the chest wall for 1-3 minutes just before the breastfeeding session.
It will help draw your nipple out for the baby to grasp easily (3).
7. Nipple stimulation before Nursing
Try stimulating your nipple just before nursing by gently rolling it between your thumb and index finger for 1-2 minutes.
Then quickly apply a moist, cold cloth to your nipple. This will help your flat nipples to stick out for breastfeeding. Avoid prolonged use of a cold cloth on your nipple as it can inhibit let-down.
8. Pull your Beast Manually
Hold your breast with the thumb on the top of the breast and four fingers underneath it. Bring out a nipple by slightly pulling on the breast tissue toward the chest wall.
Express some breast milk onto the nipple to interest the baby’s feeding instincts. Once the baby opens his mouth wide, aim your nipple toward the roof of the baby’s mouth.
If the aforementioned tips and tricks do not work for you, use the suction devices mentioned below to help with breastfeeding with flat nipples.
Research studies (4) have suggested the use of shells, cups, shields,s and nipple extractors to make flat nipples stick out for breastfeeding.
9. Try a Breast Shell
Breast shells are worn between feedings. The breast shell has a hole that fits over the nipples. The shell put gentle pressure on breast tissue when worn, to draw the nipple out. They are worn 1 hour before nursing. Unlike nipple shields, they are not used during feeding. Prolonged use of breast shells can cause a clogged milk duct or tender spot on the breast so avoid prolonged use of it.
10. Try a Breast Pump
Right before nursing your baby, use a breast pump. The suction of the breast pump can help flat nipples to stick out for breastfeeding (5). This will help your baby to latch on easily.
Try an automatic double electric breast pump, which uses uniform suction to draw the nipple out rather than compressing the areola. The good news is most insurance company covers the cost of it. Here are two brands I trust:
- Medela Pump in Style Advanced Double Electric Breast Pump
- Lansinoh Smartpump Double Electric Breast Pump
11. Try a Nipple Shield
A thin, flexible silicone shield is worn over a nipple during feeding to help draw out a nipple (6). The shield has holes in the center to help milk flow through when the baby is sucking.
If you are considering using a nipple shield, consult a lactation consultant, because if not used properly it can result in low milk supply, clogged milk ducts, and poor weight gain in the baby.
To learn about how to and who should use a nipple shield and nipple shield review, refer to this article.
12. Try a Nipple Everter
This little tool is a device with a flange attached to a bulb. It helps to draw out a nipple to help the baby latch. Use it just before nursing by placing a flange over your nipple. The suction created by squeezing the bulb gently pulls the nipple out.
Many moms with flat nipples used Latch Assist Nipple Everter successfully to help stick out flat nipples for breastfeeding.
Are Flat Nipples a sign of Breast Cancer?
A flat nipple or inverted nipple itself doesn’t mean a sign of cancer. Some women have a flat nipple that looks like an inverted nipple or some women develop an inverted nipple over time.
Like the rest of our body, a change in nipple appearance happens over time and it is considered normal.
However, it is important to be familiar with our nipple and any sudden physical changes, sore nipple or newly inverted nipple could warrant a check-up with your physician.
Breast cancer is often not associated with any nipple changes, but it is important to talk to a doctor about it to rule out any underline cause.
A flat nipple can make breastfeeding little challenging for some mama, but it doesn’t mean that it is impossible. With all the tips and tricks mentioned above, you should have no problem breastfeeding with flat nipples!
If you are having trouble with breastfeeding, get all the help you need to make it work. Think about all the benefits it brings to you and your baby.
Remember, The first month with a newborn is hard and you are doing everything you can to make breastfeeding work, so give yourself grace.
You have got this, mama!!
How About You?
Are you struggling with flat or inverted nipples? What helped you make your flat nipples stick out for breastfeeding?
- Tobon H, Salazar H. Ultrastructure of the human mammary gland. II. Postpartum lactogenesis. J Clin Endocrinol Metab 1975;40:834-44.
- Zucca-Matthes G, Urban C, Vallejo A. Anatomy of the nipple and breast ducts. Gland Surg. 2016;5(1):32-6. doi:10.3978/j.issn.2227-684X.2015.05.10
- Cotterman, K. J. (2004). Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement. Journal of Human Lactation, 20(2), 227–237. https://doi.org/10.1177/0890334404264224
- Yukun, L., Ke, G. & Jiaming, S. Aesth Plast Surg (2016) 40: 707. https://doi.org/10.1007/s00266-016-0675-0
- Jiang B, Hua J, Wang Y, Fu Y, Zhuang Z, Zhu L. Evaluation of the impact of breast milk expression in early postpartum period on breastfeeding duration: a prospective cohort study. BMC Pregnancy Childbirth. 2015;15:268. doi:10.1186/s12884-015-0698-6
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