Many women mentally prepare themselves for parenthood prenatally. One of the questions they ask themselves is, “What are the best nipples for breastfeeding?” I have had women approach me, after or during a breastfeeding class, concerned their breasts or nipples weren’t going to work for breastfeeding. Babies who are latching effectively aren’t latching to the nipple, they are latching to the breast. However, there are situations with nipples that do cause challenges. Those include: flat nipples, semi inverted nipples, and true inverted nipples.
One type of nipple that causes a pregnant woman concern is inverted nipples. I have seen hundreds of pairs of nipples. I have only seen true inverted nipples in breastfeeding textbooks. I have seen retracted or flat nipples prenatally and while working with a woman latching her baby.
How can you know if you have truly inverted nipples or if you have partially inverted or flat nipples? Simple! If you take your forefinger and your thumb and squeeze on the areola, you will see them peek out. If they peek out (evert), then you may still have some issues with latching, but you don’t have true inverted nipples. Another way you could find out if your nipples are truly inverted, is to ask your partner how they respond to stimulation when you two are intimate. Do they come out with stimulation or when you are cold? If they become erect, then they are not truly inverted. You should be able to use your nipples for breastfeeding.
One client was told after the birth of her now 18-year-old and with her now 14-year-old that she had inverted nipples. She had many difficulties with breastfeeding and wound up formula feeding both of them. Fast forward to two years ago when she reached out to me pregnant with her third baby. She was determined to breastfeed and wanted to know if based on her experiences if there was hope this time around. I asked her husband if they were able to be everted during stimulation during intimacy and he said yes. The woman did have challenges the first two weeks (more due to baby being born via c section and being born at 36 weeks than her nipples.) This woman successfully breastfed for over a year before deciding to wean her toddler.
Flat nipples in their resting state are flush with the areola. They typically are easily stimulated to erecting. Flat nipples prenatally are usually not problematic for breastfeeding success. Flat nipples also happen around 3 to 5 days after birth due to engorgement. When breasts are full and engorged it is difficult for baby to latch on. Baby latching to an engorged or full breast is like if we tried to bite a basketball. Reverse pressure softening can push fluid and fullness away from the nipple and areola allowing baby to have an easier time latching on to looser breast tissue (Again, because babies latch on to the breast and areola not the nipple when effectively latched.) These types of nipples are suitable for breastfeeding.
Truly inverted nipples do not become erect and the suction caused by breastfeeding and pumping can be painful. It can also damage the nipples. This is very rare, and if you are concerned of having truly inverted nipples, contact a lactation professional to discuss options. These nipples for breastfeeding can potentially cause challenges. These challenges can be met by communicating with a professional lactation consultant prenatally and in your early postpartum period.
With all this talk of nipples and challenges, you may also be concerned if breastfeeding hurts. Breastfeeding is not supposed to hurt. If breastfeeding hurts, it’s usually as sign that baby is not latching well. It is important to ask for help at the first signs of pain. My rule of thumb for clients is that on a scale of one to ten it shouldn’t hurt above a 3. If you are consistently having pain while latching, you may be damaging your nipples. Breastfeeding should feel like a gentle tug.
In the first few days of breastfeeding, however, it is normal to have uterine cramping. Uterine cramping in the first few days is a sign that breastfeeding is going well. It can, however, be very uncomfortable. So if it is a sign that things are going well, why does it happen? Uterine cramping is stimulated by the same hormone oxytocin that stimulates milk ejection. The benefits of feeling this cramping is that it is your uterus is going back to a smaller postpartum size.
You may also wonder if there is a way to prepare your breasts for breastfeeding. The answer is no. Pregnancy prepares them for you. If you still have concerns, contact a lactation professional.
To review: there is a lot of variety of nipple sizes and shapes. Because babies breastfeed, not nipple feed, the only type of nipples that are truly problematic for breastfeeding, are true inverted nipples. In other words, if you have nipples, you have the best nipples for breastfeeding. If you are concerned that you may have true inverted nipples, please reach out to a lactation professional. Breastfeeding shouldn’t hurt, though a little discomfort is normal. If you have pain, get help immediately. Reaching out for help at the first sign of an issue helps small problems stay small.
If you have any questions or concerns, the best thing to do is ask a professional prenatally. Please feel free to reach out to us. We want to help you reach your breastfeeding goals.