Breast feeding and flat nipples

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The size and shape of nipples and breasts vary widely between women. These differences have little to do with the ability to breastfeed—though if one or both nipples are flat or inverted some mothers find that establishing breastfeeding takes a little extra time and patience in the early days. Inverted nipples?

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Nipples and breasts come in all shapes and sizes and not always in matching pairs. Not all nipples protrude like half a cherry on a cup cake. Some nipples may be quite shallow or flat, perhaps level with the areola, others can be dimpled or folded, very long or wide.

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All A-Z health topics. View all pages in this section. Breastfeeding can be challenging, especially in the early days.

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Actually, your ability to breastfeed has little to do with the size and shape of your breasts. Breast shape is seldom significant, and nipple shape poses a problem for only a small number of women. It may be a little more difficult for women with inverted nipples to get their baby to latch onto the breast well, but with preparation and knowledge, most women with flat or inverted nipples will experience few problems with breastfeeding. Another sign of flat or inverted nipples is no movement of the nipple when stimulated or in response to cold.

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Inverted nipples do not protrude from the level of the areola but are retracted inwards instead see image below right of an inverted nipple compared with a normal nipple. Some severely-inverted nipples are fully stuck inwards while others can be drawn out with suction, such as with a breast pump or syringe. Flat nipples are level with the areola.

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Gently compress your areola the dark area around the nipple about an inch behind your nipple. If the nipple does not become erect, then it is considered to be flat. If the nipple retracts, or becomes concave, it is considered to be inverted.

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There's a lot of confusion surrounding whether inverted nipples can affect breastfeedingwhich makes sense—both breastfeeding and nipples can be confusing. Some nipples point out from the breast, some are inverted and pulled into the breast, and still others are somewhere in between, lying flat against the breast. The good news is that no nipple shape automatically makes breastfeeding off-limits.

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Nipples come in all shapes and sizes and not all nipples point out away from the breast. Some nipples are flat while others are inverted and pull into the breast. Or, nipples may fall somewhere in between.

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However, it is still possible to breastfeed using nipple shields. Nipple shields are thin silicone covers that can be placed over the nipple to assist with breastfeeding. It is recommended that baby eventually feed directly from the breast and attempts to do this should be made after a week or two.

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If you have flat or inverted nipples, it is possible to breastfeed — it may just be more of a challenge and require some assistance and patience. If a baby is unable to feel the nipple, this may cause frustration for mom and baby! You can check for flat or inverted nipples by performing a simple test. Gently compress your areola with your thumb and index finger about an inch behind your nipple.

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