Flat or inverted nipples are a common anatomical variation that can present a challenge for successful breastfeeding, as the baby requires a pronounced nipple and surrounding areola to achieve a deep, effective latch. This situation occurs when the connective tissue or milk ducts pulling the nipple inward are too short or rigid. While this structural difference can make the initial latch difficult, it does not prevent breastfeeding entirely. Many practical and safe methods exist to help the nipple temporarily or permanently evert. The goal is to encourage the nipple to protrude just enough to provide a firm, graspable target for the infant, making the process smoother for both mother and baby.
Quick Manual Techniques Before Latching
Immediate, hands-on techniques can be used moments before a feeding session to stimulate the nipple tissue and encourage protrusion. One simple method involves gently rolling the nipple between the thumb and forefinger for about a minute, helping the nipple become firmer and more prominent. Another helpful action is the “tug test,” a gentle stretching or pinching motion around the areola. By placing the thumb and forefinger on opposite sides of the areola and pressing lightly inward toward the chest wall, the nipple can be encouraged to pop out by loosening the underlying tissue. Temperature is also an effective, quick stimulant: applying a cold compress, like an ice cube wrapped in a thin cloth, for a few seconds causes temporary vasoconstriction, making the nipple more pronounced right before the latch attempt.
Specialized Devices for Temporary Eversion
Several specialized tools are available to help draw out the nipple just before or during a feed, serving as immediate, short-term aids. One device is the nipple everter, often designed as a small syringe or suction cup that creates a gentle vacuum over the nipple. By pulling on a plunger or bulb, the everter applies negative pressure, which temporarily stretches the underlying tissue and pulls the nipple outward. This effect typically lasts long enough for the baby to initiate a successful latch.
Another common aid is the nipple shield, a flexible, thin piece of silicone worn over the nipple and areola. The shield provides a firmer, more defined shape for the baby to latch onto, effectively mimicking a more everted nipple. Nipple shields offer a consistent target that facilitates the necessary vacuum seal. Ensure the nipple shield is correctly sized to prevent discomfort and maximize its effectiveness; it should generally be viewed as a temporary tool. Some mothers also use a breast pump for a minute or two right before a feeding to achieve temporary eversion through suction. This action draws the nipple out and softens the surrounding areola tissue, making it easier for the baby to take a deep mouthful of breast.
Prenatal and Ongoing Correction Methods
For mothers looking for a more sustained change in nipple shape, methods designed for consistent, longer-term use are available, sometimes beginning before the baby is born. The Hoffman technique is a manual exercise regimen intended to gradually loosen the fibrous adhesions at the base of the nipple. This involves placing the thumbs opposite each other at the base of the nipple, pressing firmly into the breast tissue, and then gently pulling the thumbs away from each other in two directions (horizontally and vertically) several times a day.
Nipple shells, also known as breast shells or formers, are dome-shaped plastic devices worn inside the bra between feedings. These devices have an opening that fits over the nipple, and the gentle pressure they apply to the areola encourages the nipple to protrude over time by stretching the tissue and maintaining the nipple in an everted position for extended periods throughout the day. Consistent use of a breast pump can also work as an ongoing method to stretch the tissue and maintain eversion. Individuals considering any long-term method, particularly during pregnancy, should consult with a healthcare provider first.
Consulting a Lactation Professional
If manual techniques and devices do not sufficiently address latching difficulties, or if the nipple is severely inverted, consulting a lactation professional is a sensible next step. A professional can help determine the degree of inversion, often classified by a grading system (Grade 1 being easily everted, Grade 3 being permanently inverted). This assessment helps tailor the most effective strategy. A certified lactation consultant can observe a feeding session to troubleshoot underlying positioning or latching issues, which may be the primary barrier rather than just the nipple shape. They provide personalized guidance on how to use tools like nipple shields correctly, focusing on optimizing the baby’s ability to transfer milk and offering comprehensive, individualized solutions for significant inversion.