Lets be honest. As women we would love to have long, everted nipples if we plan to breastfeed. Many women think that they have flat or inverted nipples and therefore will have a hard time breastfeeding. Some are so discouraged, they don't even try. It is a misperception that in order to be successful at breastfeeding we have to have nipples that any baby would appreciate.

The Good News!

You dont even need nipples to breastfeed. An infant latches over the nipple onto the breast, not onto the nipple!! So it doesnt matter the size of the nipple. I will explain the types of nipples, description and how to successfully breastfeed. The bottom line is you can still breastfeed no matter the shape, size, or direction of your nipples.

Inverted Nipples:

In my experience as a lactation consultant, these type of nipples are the most challenging. To know that you have true inverted nipples, regardless of a dimple or crease in the nipple, you need to pinch the sides of the nipple and the nipple goes in and hides. It will help if the mother has a protruding areola. You may then use the extra tissue from the areola to make a ridge that becomes the nipple. First of all, giving a baby a bottle or pacifier will make your efforts in teaching the baby harder. If the baby will not latch, get a lactation consultant or nurse to come and help you. If a lactation consultant isnt available right away, express your colostrum onto a spoon and have the baby lick off the colostrum.

Until help arrives, hopefully only a few hours, express at least one spoon full of colostrum at each feeding. Note: the milk is in the back of the breast. Hold your breast as if holding a sandwich or in the C hold. Keep your fingers away from the areola. Compress back towards you chest wall and roll your fingers forward. Avoid pinching the nipple to get the milk out as this will only serve to hold the milk in. Also try pumping using the suction to bring the nipple out of hiding. When the nipple protrudes a little, get the baby on immediately. Using nipple shields is an option but first see a certified lactation consultant first to determine if this is the best route.

Flat Nipples:

I hear every day that one of my patients has flat nipples. If the nipple becomes a little longer with stimulation from a pump, the baby sucking, or massaging the nipple, then the nipple isnt flat. Flat nipples stay flat no matter what stimulation you may try. The true flat nipple appears to have no shape or contour. Hopefully, the mother has a protruding areola that will help compensate for not having the nipples protrude. It is a great help to keep the breasts soft. Using the areola or breast tissue when the breast is soft can trick the baby into thinking the nipple is larger than it is. Some Moms need to pump or hand express for a few minutes before every feed to help bring the nipple out a little. Sometimes engorgement will make these nipples flatter, and Mom may need to express for longer periods to soften the breast so she can use the breast tissue as part of the nipple. Note: Avoid any rubber nipples. This will only teach the baby that there are "easier" nipples out there, therefore making the baby upset that he has to work harder with flat nipples.

Short Nipples:

These types of nipples are usually mistaken for flat. Short nipples have some shape or formation on the breast. Most women have nipples that fall into this category and babies do just fine, especially if the baby hasnt been exposed to any rubber nipples. The truth is that if we dont tell the baby there is a problem, the baby wont know the difference. So dont allow the baby to experience a "different" nipple. Just make sure that the baby latches over the nipple and does not suck at the tip.

When in doubt, it is most important to have Mom and baby do continual skin-to-skin. (No clothes between the Mom and baby.) This will help the baby instinctively breastfeed. Secondly, contact a breastfeeding professional for further assistance.