Q&A: Can I nurse if my nipples are inverted?

Yes, you should be able to breastfeed. In some cases it may require a bit of work and assistance from a lactation consultant, but it can be done! In my career as a nurse and lactation consultant, I have seen many variations of breasts and nipples. Luckily, there are many tricks and tools we have to help moms whose nipples are inverted.

What are inverted nipples? An inverted nipple is one that does not stand out on its own. Some moms may have flat nipples and some may have truly inverted nipples. (You can do a pinch test during pregnancy or meet with a lactation consultant if you have questions about the status of your own nipples.) Using your thumb and index finger, hold onto your areola about an inch from your nipple and gently squeeze. Your nipple will do one of three things: stand out, remain flat or become inverted—kind of like belly button! When a woman's nipples are inverted, it is usually as a result of adhesions (acting much like a rubber band) holding the nipple back or pulling it in. Depending on how inverted the nipple is and how well your baby can latch will determine your ability to nurse. Many times after a baby gets started with nursing, the nipple will improve and stand out more easily.

Some of the strategies that may be used to assist you if you do have inverted nipples include:

• Using breast shell periodically during pregnancy and also 30 minutes before you nurse to help your nipples stand out and loosen adhesions.
• Manual stimulation before feedings to help the nipple "stand out" (rolling or gently tugging on nipple just prior to latching your baby can help).
• Using a breast pump for a few minutes prior to nursing to help coax the nipple out.
• Using a breast shield. This is different from a breast shell and is a thin, silicone nipple that fits over your own nipple. It has holes in the end to allow your milk to come through. This should be used with the guidance and support of a lactation consultant. (If not used properly it may affect how efficiently your baby removes milk form your breast and in turn decrease your ability to produce enough milk.

My grandmother told me she had inverted nipples and was unable to nurse her children. Realizing mine were inverted, I obsessed about it for the entire nine months of my first pregnancy. I read every book and watched every video I could find. I stuck plastic cups inside my bra to try and draw out my nipples in advance of giving birth; and I yanked and tugged every chance I got. When my son was born, I was in a panic; he would not latch on at first, but with a little help, he did it! I nursed two babies for more than 12 months each. Neither of them ever tasted formula. And I still have inverted nipples.

Good luck!