Breastfeeding with Flat Nipples: Is it Possible?

What are Flat Nipples?

Flat nipples do not bulge and are level with the rest of the breast. While nipple protrusion usually increases during pregnancy for most mothers, some may have flat or inverted nipples, causing anxiety about direct breastfeeding. The Pinch test, where gently squeezing the areola causes the nipple to bulge, can determine if it will bulge during breastfeeding, even if it initially appears flat.

Can You Breastfeed with Flat Nipples?

Many mothers mistakenly believe they cannot breastfeed directly and may need to resort to pumping breast milk and bottle-feeding. In fact, during a proper latch, the baby doesn't just grasp the nipple; he encompasses more breast tissue for a deep and practical latch, making breastfeeding successful and pain-free. With some additional effort and guidance from lactation specialists, mothers can breastfeed their babies directly, even with flat nipples.

Tips to Facilitate Direct Breastfeeding With Flat Nipples

Skin-to-Skin Contact

The mother must engage in skin-to-skin contact immediately after birth, during the so-called "golden hour." Continuing to touch and cuddle the baby during the first days and weeks, whether during breastfeeding sessions or while the baby sleeps, is vital.

Feeding On-Demand

Mothers are advised to breastfeed the baby as soon as signs of hunger appear. Initiating breastfeeding when the baby is only mildly hungry makes latching onto the breast with flat nipples much easier.

Manual Breast Stimulation

Hand expression of breast milk can make breastfeeding with flat nipples easier. This stimulates the release of a few drops of milk, encouraging the baby to latch onto the breast more easily.

Learn the Correct Latching Technique

Understanding the proper and deep latching technique is crucial for successful breastfeeding. Mothers should familiarize themselves with this technique even before childbirth, making breastfeeding easier and less painful, whether they have flat nipples or not.

Breast Compression During Breastfeeding

Mothers can gently compress the breast while breastfeeding to facilitate milk flow and encourage the baby to continue nursing directly.

Ice Packs

Using ice or cold compresses can bring flat nipples out. Mothers can apply ice for a few minutes before breastfeeding to make breastfeeding easier.

Avoid Breast Engorgement

Breast engorgement is common, especially in the early days of milk production. When the breast becomes engorged, the nipple tends to flatten more. It is important not to breastfeed during engorgement. Mothers can alleviate this by manually expressing some milk to reduce nipple flattening or using a breast pump for a short time to ease latching for the baby.

Avoid Nipple confusion

It is crucial not to introduce artificial nipples, such as bottles or pacifiers, to a baby struggling with latching onto a flat nipple. Giving the baby a bottle can make direct breastfeeding seem more challenging. Communicating this to the hospital staff is essential, ensuring the baby becomes accustomed to direct breastfeeding.

Utilize Tools for Easy Breastfeeding

Direct breastfeeding with flat nipples can be challenging, requiring the use of certain tools. The supplemental nursing system depicted below is one such tool. It ensures the baby receives breast milk while stimulating the nipple as they suck on a tube. Spoons, cups, or syringes can also be used to feed the baby expressed milk, avoiding bottle usage.

Other helpful tools include nipple formers, which mothers can wear between feeds, as shown in the image.

Don’t rush the use of Nipple Shields

Using nipple shields should be a last resort after trying other solutions. Nipple shields may have a similar effect to baby bottles, and the baby may become accustomed to them instead of the natural breast. If necessary, nipple shields should be supervised by a lactation specialist to ensure proper breast stimulation and effective breastfeeding. Removing the shield halfway through the feed encourages the baby to latch directly and reduces dependence on the tool. Regular cleaning is crucial to prevent infections. Monitoring the baby's weight and diaper count helps ensure proper breastfeeding.

Dear mothers, breastfeeding with flat nipples may pose challenges, especially in the initial weeks postpartum. However, it is achievable with the right approach, support, and knowledge. With personalized guidance and assistance from a lactation specialist who can tailor a plan and solutions that suit you and your baby.

Also read Breast Lumps During Breastfeeding: Causes and Treatment