# Flat/Inverted Nipple photos



## USAmma (Nov 29, 2001)

Okay, I don't want to embarass anyone, but I posted photos of my flat/inverted nipples on my parenting website, for educational purposes only!!

I didn't know I had this problem until after I gave birth. Two LC's and one LLL leader later, never did get her to the breast and ended up pumping full time. I had suspected that my nipples were not normal after taking a bfing class and seeing these huge ones on the videos, but my doctor (like he knew anything) said they were fine. I didn't know there was such a condition until it was too late.

Anyway, just FYI. Please feel free to pass this on to anyone who might need to see it, hopefully before their baby is born so they can get some help to overcome this problem. It's MUCH harder to get a baby to latch on after you are engorged, esp. with flat/inverted nipples. I want to save others the trouble and heartbreak I went through.

http://www.home.earthlink.net/~sukum...atnipples.html

Hope it's okay to post this here. This is for educational purposes only!! I have not found any really good photos of flat/inverted nipples, only drawings.

Darshani


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## mrzmeg (Jul 16, 2002)

Wow! Thank you for posting that---it explains so much. My nipples have that same indentation in the center. My ds is almost four months old and I still have a lot of nipple soreness, and they are bruised. DS doesn't have a problem latching, but I have had these horribly painful bruises since he was born. Now I know what to ask about the next time I talk to a LC.
Thanks.


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## Bladestar5 (Jan 5, 2003)

I also have fairly flat nipples, especially on one side, at first I had to pump, especially with dd, but they are fine, now. I think some women's nipples stick out TOO much!


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## DaryLLL (Aug 12, 2002)

A reminder for women with flat or inverted nipples: babies don't nipple feed, they breast feed. many babies can latch on to a breast with flat or inverted nipples and do just fine. But if you are haivng problems with latch on or soreness, here is what to try:

Wear a breast shell, available from Medela, between feedings. Do not confuse this witb a breast sheild, worn during a feed.

Try the Hoffman technique: Place a thumb on each side of the base of the nipple. Not at the edge of the areola. Press in firmly against the breast while pulling the thumbs away from each other. Repeat 5x/day, moving thumbs around the base of the niple.

Use a breast pump or syringe designed for this problem, before a feed, to draw out the nipple.

When feeding, express some milk onto the nipple to entice the baby.

When latching on, try pulling back slightly on the breast tissue to help the nipple protrude. As you hold your breast, thumb on top, fingers underneath and behind areola, pull back slightly on breast tissue toward the chest wall.


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## chellemarie (Jan 17, 2003)

Thanks for sharing that. One of my nipples looks like that but so far, it's not caused any latching problems. I massage to bring it out and if I'm really full (TMI WARNING) dh can help. *ahem*

It happens to be the same nipple that had trauma since the last baby was weaned. I was shaving my right underarm in the tub, needed to do the other underarm, switched the razor from my left hand to my right and swung the razor and my hand in front of my body much too close and sliced the nipple directly across the center.

I'll never again complain about nicking my knees while shaving. Holy Toledo.

Hopefully it didn't do anything that will cause problems nursing this baby.


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## Bladestar5 (Jan 5, 2003)

that HURT just thinking about it OUCH!!


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## USAmma (Nov 29, 2001)

OMG that must have really HURT!! Be careful!

And back to topic, 4 months of exclusive pumping didn't correct my problem. Guess they just like being flat. My dd could not latch on to my areola either, and when she tried to draw the nipple out it went in instead, and she lost her latch. At least that's what the 2 LC's said. I was also constantly engorged thanks to Oversupply Syndrome. Oh well, I have a lovely little girl and am counting my blessings, not my failures.

Darshani


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## DaryLLL (Aug 12, 2002)

Yowch chellemarie! That makes my eyes roll into the back of my head. Be careful!

Usamma- I know you really tried, and got LC help. Your nipples were just really stubborn, huh? good for you for pumping for 4 mos. If all the ideas for pulling out yr nipples didn't work, did you try and breastfeed using a shield during feeds?


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## USAmma (Nov 29, 2001)

Quote:

, did you try and breastfeed using a shield during feeds
I wanted one right away to try, but no one would let me try one. In my state you have to get a prescription for them, which is great except when you really have tried everything else. The first LC would not let me try one and was just happier to rent me a pump. (ugh!). The second LC was from out of state and she did call one in for me but Abi was 4 mos. old by then. She suckled for about 30 seconds and then decided she didn't like it. She was so used to bottles at that time, and the shield took more effort for her because the nipple part was smaller than those of her wide-mouthed bottles.

I've still got that shield and the shells, but honestly I'm really not willing to try very hard to bf next time. It was really, really hard on me (I had super overactive letdown and oversupply problems too, for the whole four months I pumped). But at least I know more than I did when I had Abi.

It's ironic-- my friend's SIL in India just had twins and was having a hard time nursing them with latch on, engorgement, and overactive letdown. She was about to throw in the towel. I was able to send her lots of great tips over email, and she is now nursing then exclusively! So at least I feel like my struggles were for something. If I can't nurse I can at least help others to.

Darshani


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## DaryLLL (Aug 12, 2002)

That's right, darshani, it feels so good to share parenting exp with others.

Just a little encouragement to try again next time. It may not be all your nipples fault bfing didn't work out. It may have had something to do with your child's mouth--lips, tongue, palate, that impeded her ability to latch on despite flat/inverted nipples. Your next child (should you be so blessed) may have, say, a longer tongue, a stronger suck, or whatever. Of just a more energetic or easy going personality? I don't know if these will apply, just want to offer gentle encouragement.


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## USAmma (Nov 29, 2001)

Daryl, I appreciate the encouragement. Abi's had oral issues her whole life so far- had bad reflux as an infant, has a strong gag reflex (like her mommy), took an interest in solids very late in life, still won't eat mixed textures, and still prefers liquid "meals" over solid foods at 25 months old. So maybe it's just her. I won't totally refuse to try, just not expecting much. But hey, maybe I'll be surprised.

Darshani


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## flminivanmama (Nov 21, 2001)

darshani - your nipples look exactly 100% like mine. but like Daryl said - babies don't nipple feed, they breastfeed. It sound like there was a lot more going on there & if you have another one you can get past all those problems with better help then you got last time.


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## phoebekate (May 31, 2002)

USAmma, thanks for posting your photos, I had no idea I had flat nipples until way too late - despite having done an antenatal breastfeeding course and consulting an LC before DD was born to make sure I had done everything I could to be prepared.

I have been stewing over this for days and not saying anything because I know your intentions are the best DaryLLL, but i have decided I really should speak up. As a woman who went through flat nipple hell to breastfeed there are few comments I find as trite or offensive as "babies don't nipple feed, they breastfeed". A couple of the many LCs I saw came out with this jem at the time and I a) had an overwhelming urge to slap them b) didn't revisit them. My whole breast(s) suffered, but it was my nipples that were the root of my problems.

My history in brief: I had grazes, bruises, then cracks, then gaping holes, blocked ducts, engorgement, 4 bouts of masitis in 3 months, cellulitis requiring antibiotics for only the second time in my life, vaso spasm, was unable to leave the house for about 6 weeks because I couldn't wear clothes (not just no bras, no tops, no nothing), etc... I think the only problems I didn't have were low supply and thrush. For a few days I had to do every feed on my hands and knees hanging over DD while DH held my breast in her mouth because gravity was the only thing that would get the milk out, unfortnately we never got any video of this, it was pretty funny... Around 8 weeks it started getting a bit easier, by 3 months I could feed in public (because I didn't need to cry through feeds anymore). Around 4 months it was just unpleasant most of the time not painful, and I guess it was about 6 months I just stopped noticing any sensation at all. DD is now 11 months and still exclusively breastfeed, two weeks ago another mum (of a 3 month old) said to me "after we left your place the other day my husband said to me 'you make feeding look easy, but she makes it look like nothing at all'", It made me realise just how far I have come.

I have met a number of women who have kept breastfeeding through similar levels of difficulty to me, one who had worse problems than me and fought for 6 months before giving up and far far more who give up for what seem to me to be pretty pathetic reasons ("Oh I had to give up at 2 weeks because I had cracked nipples"). But all the women I have spoken to with serious flat nipple issues have had similar stories, the advice they got was unrealistic at best and crappy at worst. The worst advice I got was from the best LC in my town, the one that trained all the others, that they go to themselves. The best advice I got was from my GP (who is a certified LC herself, and visited the other LC herself twice), her advice being "you are doing everything right, nothing is going to make this better but time, you just have to keep going, you will turn a corner by about 8 weeks". She was also the only one to make the very interesting observation that in her experience it is the women with really flat nipples that also have really fiborous nipples which WILL NOT be drawn out, this was certainly the case for me and you know what, after 11 months of breastfeeding my breasts are actually a fairly typical breast shape for the first time in my life. Before breastfeeding they were more like downward pointing cones with a very strong mind of their own. I feel very lucky that the pain stopped for me, I know a woman who is nursing her second child and after a total of 2 years breastfeeding (1 year each) every feed still hurts, and yes they are latched on properly. the advice that it won't hurt if they are latched on properly just doesn't seem to hold true for women with nipples like mine (or worse) and the idea that with a good latch it won't hurt even if your nipples are cracked is just plain stupid. If your nipples hurt when nothing is touching them they are going to hurt when your baby sucks on them, no matter how good the latch is.

I am sorry this is all over the shop, its late. I guess I just really wanted to stress that I feel you should think about how you talk to women dealing with flat nipple problems. OF COURSE make sure they are getting enough breast in the babes mouth, OF COURSE make sure they latch is the best it can be. But don't say things like "babies don't nipple feed, they breastfeed" and don't assume it won't hurt once the latch is right. The LCs that insisted that it wouldn't hurt if I had a good latch, then watched and said "perfect" and then looked puzzled when I wept in pain just made me feel bad and that I was doing something wrong. I am very thankful for my GP insisting I was doing everything right (and she spent hours, over weeks determining this, not minutes) but was just damn unlucky and would have to grin and bear it until things got better, her respect and honesty got me through. Sometimes the best help is acknowledging that only time will fix the problem and that getting through until then will be HARD work.

Oh and DD was checked for high arched palate, tounge tie, etc in her first days of life, these were not contributing factors.


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