Breastfeeding Positions For Inverted Nipples

Introduction

Breastfeeding is an essential aspect of nurturing widely acknowledged as beneficial to both mother and child. However, it is not always intuitive to all mothers, especially those with inverted nipples. They may wonder if breastfeeding is possible with inverted nipples. 

What is an inverted nipple? 

An individual is said to have an inverted nipple when the nipple is below the plane of the areola. It can be present at birth or acquired, occurring in both genders. Women with inverted nipples, however, are more concerned about the appearance and functionality of their breasts, particularly concerning sexuality and breastfeeding. 

It is important to note that nipples have variations, including inverted nipples, but this doesn't make them abnormal. It’s a normal variation present in about 10%-20% of the population.¹ In a few cases, it may be pathological. In this article, we will explore tips for successful breastfeeding with an inverted nipple. Yes, it is entirely possible to breastfeed with the nipples inverted; let's see how.

Identifying inverted nipples

Before delving into tips on breastfeeding with inverted nipples, it is important to learn how to identify this variant of nipples. 

To check for inverted nipples, gently squeeze the areola behind the nipple. If the nipple flattens or retracts into the breast instead of pointing out, it is likely inverted. 

It's crucial to differentiate between congenital and acquired cases and rule out any underlying health concerns, especially in acquired cases, where a medical examination can help exclude breast cancer. Nipple inversion becomes worrisome when it is acquired and accompanied by bloody or serous discharge. The presence of lumps in the breast in association would also raise concerns about possible cancer. 

In the next section, we will delve into techniques and tips for preparing inverted nipples during pregnancy and ensuring a positive breastfeeding experience.

Preparing inverted nipples during pregnancy 

To facilitate breastfeeding for expectant mothers  with inverted nipples, they are encouraged to prepare during pregnancy, and this can be done in  a couple of ways, including:

Embracing the normalcy of inverted nipple

Every woman's body is unique, and it is not uncommon for nipples to vary in appearance. Around 10% of women may have flat or inverted nipples, meaning the nipple doesn't protrude outward as much as typical nipples. Mothers need to realize that these variations do not prevent breastfeeding, and successful nursing is indeed possible with the right techniques and support.

Using nipple formers or breast shells

During pregnancy, you can use nipple formers or breast shells to gently draw out your inverted nipples. These are soft, flexible silicone discs that fit inside your bra and put gentle pressure on the nipples. This can help encourage the nipples to become more prominent and easier for your baby to latch onto when breastfeeding. Research has found that breast cups/shells are largely effective in helping expectant mothers prepare for breastfeeding.

Tips for successful breastfeeding with inverted nipples 

Mothers with inverted nipples face challenges with breastfeeding due to inadequate infant latching, which may result in poor milk flow and the baby not feeling satisfied.³  This may lead to mothers giving up on exclusive breastfeeding prematurely. However, mothers with this condition can breastfeed successfully with the right techniques. By following these guidelines, mothers can overcome potential challenges associated with inverted nipples and create a rewarding breastfeeding journey.

Importance of skin-to-skin contact

Skin-to-skin contact between the mother and baby is a crucial aspect of successful breastfeeding. This practice fosters a strong emotional bond and promotes breastfeeding initiation. For mothers with inverted or flat nipples, skin-to-skin contact allows the baby to explore and locate the breast more easily, enhancing the chances of successful latching. Spending time with the baby skin-to-skin immediately after birth and during subsequent feeds can significantly improve breastfeeding outcomes.^4,5

Hands-on stimulation to aid attachment

Before a feeding session, gently massaging or rolling the nipple between the fingers can encourage the nipple to protrude slightly. This preparation can make it easier for the baby to latch on and obtain a sufficient mouthful of breast tissue, ensuring a comfortable and productive feeding experience for both mother and baby.⁵

Utilising breast massage and shaping before feeds

Breast massage and shaping techniques can further assist in preparing the breast for nursing. Gentle massage of the breast before feeding encourages milk flow and softens the areola, making it easier for the baby to latch. Additionally, shaping the breast into a "breast sandwich" position – using the C-hold technique to compress the breast slightly – can provide a larger and more accessible area for the baby to latch onto. These methods are particularly helpful for mothers with inverted or flat nipples, as they promote successful attachment and reduce potential discomfort during feeding sessions.⁶

Temporary use of nipple shields if needed

Nipple shields can be a valuable tool for mothers facing challenges with inverted or flat nipples. These thin, flexible silicone shields are placed over the nipple and areola, creating a temporary bridge between the breast and the baby's mouth. Nipple shields can help draw out the nipple and make latching easier, particularly during the initial breastfeeding attempts. However, it is essential to use the correct size and seek guidance from a lactation consultant to ensure proper usage and prevent any potential issues with milk supply or latch preference.⁵

These are some of the conservative options for enhancing breastfeeding with nipple inversion. Surgical options also exist that can help with nipple projection. 

Breastfeeding position for inverted nipples

Finding the right breastfeeding position is essential for mothers with inverted or flat nipples, as it can significantly impact the baby's ability to latch effectively and comfortably. Several breastfeeding positions can be beneficial for mothers facing this challenge. These positions not only aid in proper attachment but also promote a positive and successful breastfeeding experience.

The cradle holds the position

The Cradle Hold position is one of the most commonly used breastfeeding positions. In this position, the mother cradles the baby in her arms, resting the baby's head in the crook of her elbow. The baby's body is facing the mother's body, with the baby's nose aligned with the nipple. This position allows the baby to grasp the breast with a wide mouth and obtain a good latch. Mothers with inverted or flat nipples can find success with this position by gently pulling back on the breast tissue to help the nipple protrude more, facilitating latching.⁷

The football hold position

The Football Hold position, also known as the Underarm or Clutch Hold, is particularly useful for mothers with larger breasts or after a cesarean birth. To assume this position, the mother holds the baby along her side, with the baby's legs and feet tucked under the arm like a football. The baby's head is supported by the mother's hand, and the baby's mouth is facing the breast. This position can be beneficial for mothers with inverted or flat nipples, as it provides better visibility and control for guiding the baby to latch on properly.⁷

The cross-cradle hold position

The Cross-Cradle Hold position is another effective technique for babies who have difficulty latching onto inverted or flat nipples. In this position, the mother holds the baby with the opposite arm from the breast being used for feeding. For example, if the baby is feeding from the right breast, the mother uses her left arm to hold the baby. The mother's hand supports the baby's head, and the baby's body faces the mother's body. The Cross-Cradle Hold provides excellent control for guiding the baby to latch properly and helps ensure a deep and effective latch.⁷

The lying-down position

The Lying-down position is particularly useful for nighttime feedings or when the mother needs to rest while breastfeeding. In this position, the mother lies on her side, and the baby lies facing her, tummy to tummy. The baby's mouth is aligned with the nipple, allowing for easy latching. This position is suitable for mothers with inverted or flat nipples as it provides a relaxed and comfortable breastfeeding experience for both mother and baby.⁷ 

The laid-back position (Biological nurturing)

The Laid-Back position, also known as Biological Nurturing or laid-back breastfeeding, is an instinctive and baby-led approach to breastfeeding. In this position, the mother reclines in a semi-reclined or fully reclined position, and the baby lies tummy to tummy on the mother's chest. The baby is free to move and find the breast on their own, and gravity helps the baby maintain a good latch. This position can be beneficial for babies with difficulties latching onto inverted or flat nipples as it allows for a natural and unhurried approach to breastfeeding.⁷

In conclusion, choosing the right breastfeeding position is essential for mothers with inverted or flat nipples. Mothers are encouraged to experiment with different positions to find the one that best suits their and their baby's needs.

Coping with challenges 

When dealing with breastfeeding positions for inverted nipples, some mothers may encounter challenges and discomfort along the way. Addressing these issues with patience and appropriate techniques is essential for a successful breastfeeding journey.

Addressing persistent soreness due to tight adhesions

In some cases, persistent soreness during breastfeeding may be attributed to tight adhesions in the breast tissue. To alleviate discomfort, seeking advice from a registered health professional is crucial to ensure proper evaluation and management of adhesions. Patience, along with regular support from lactation consultants or breastfeeding specialists, can help mothers cope with soreness and achieve a more comfortable breastfeeding experience.

Dealing with breast engorgement and its impact on inverted nipples

Breast engorgement, a common breastfeeding issue, can affect mothers with inverted nipples. Engorgement occurs when the breasts become overly full and swollen due to increased milk supply. For mothers with inverted nipples, engorgement can exacerbate latching difficulties. To manage breast engorgement, frequent breastfeeding or pumping can help relieve the pressure and draw out the inverted nipples. Applying cold compresses or using hand expression techniques can also aid in addressing engorgement and facilitate more effective breastfeeding.

Using pumping to draw out inverted nipples and relieve discomfort

Pumping is an effective method to draw out inverted nipples and stimulate milk flow. Regular use of a breast pump before breastfeeding sessions can help soften the breast tissue and make latching easier for babies. Additionally, pumping can aid in milk expression and relieve discomfort associated with breast engorgement. Using a high-quality breast pump and seeking guidance from breastfeeding specialists on proper pumping techniques can optimize the benefits and reduce any discomfort experienced during the process.

As with any aspect of breastfeeding, seeking support and guidance from healthcare professionals and breastfeeding experts is crucial. Coping with challenges and discomfort while breastfeeding with inverted nipples requires patience, perseverance, and a proactive approach to finding suitable techniques for each situation. 

Conclusion 

In conclusion, breastfeeding is an important recommendation for an infant's health.⁸ Having inverted nipples should not deter any mother from engaging in adequate breastfeeding. It is crucial to understand that inverted nipples are just a normal variation in some women, and with the right techniques and consultation with dedicated lactation specialists, breastfeeding can be a successful and rewarding task for the mother.

Ultimately, breastfeeding is a beautiful and natural bonding experience between a mother and her baby, regardless of nipple variation. With the right support and determination, mothers can overcome challenges associated with inverted nipples and embark on a fulfilling and successful breastfeeding journey. Remember, every mother's journey is different, and embracing these differences can lead to a positive and empowering breastfeeding experience for both the mother and the baby.