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Thread: ? - Breastfeeding with flat nipples

  1. #1
    Join Date
    Feb 2006
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    Question ? - Breastfeeding with flat nipples

    Hello - I am 36 weeks pregnant and very much want to breastfeed my baby.
    But I have flat nipples... I have been reading a lot through my pregnancy and every book and magazine I checked said it was ok and basically not to worry about this, and that even with flat nipples you should be able to nurse fine.
    Well as I'm getting closer to my due date I'm getting nervous because I am not so sure anymore... I took a class in my local hospital that was an introduction to breastfeeding and they recommended that I use breast shells. Is this good? Is it too late for me (I am 36 weeks pregnant, should I have started from the beginning of the pregnancy)? They also mentioned some nipple stimulation exercises to try to bring them out, but many books I've read say that you shouldn't do this kind of exercise since you can trigger early labor and that basically they do more harm than good. So what should I do? I am nervous because I don't have much time left to do exercises or use the breast shells, I now worry if I'll be able to breastfeed my baby or not.
    I hope this wasn't too long, I'll appreciate any help and guidance you can give me.

    Alicia

  2. #2
    Join Date
    Feb 2006
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    Default Re: ? - Breastfeeding with flat nipples

    Hi Alicia -- wow, you are so wise to bring this question up now, before the baby comes. I had flat nipples, and I wish I had taken measures even a couple weeks before giving birth to help draw them out a bit.

    You absolutely CAN breastfeed with flat nipples. Women with truly inverted nipples often find it impossible, but flat ones just pose a challenge, not an insurmountable obstacle.

    I would definitely start wearing breast shells now. They hold your bra away from your nipple and press the areola and surrounding tissue back gently, so that your nipple has gentle, constant pressure to evert. The goal in all flat-nipple treatments is to loosen the adhesions under the skin that are preventing the nipple from sticking out past the breast. Because the breast shell applies constant pressure, it doesn't stimulate the breasts or nipples and won't cause contractions. (And anyway, you're very nearly full-term now, so this isn't a huge concern IMO.)

    Once the baby comes, continue wearing the breast shells 24/7 when you aren't nursing. You may find that the flat nipples make it tricky to get a good deep latch -- especially if you have any engorgement -- imagine trying to suck on a bowling ball, and you can get a sense of how hard it is for a newborn's mouth to form a good suction seal on your breast if the nipple isn't nice and long and stretchy.

    What this means is that you would be well advised to anticipate latch problems, make sure you have reliable resources lined up, including informed lactation assistance from a board-certified IBCLC or a LLL Leader (or, less likely, L&D and postpartum hospital nurses with special training in lactation). Above all, be prepared to spend many feedings, probably several days, improving and fine-tuning the latch with your new baby. There is a steep, steep learning curve for all new breastfeeding moms, so you're not alone in this.

    The good news is that there is no more efficient nipple-everter than a newborn baby! My nipples are definitively no longer flat. Oh, one more thing -- it was my experience that although my son was latching well, for many weeks I felt brief but intense pain every time he latched. I suspect that pain was the adhesions loosening, a little more each feeding. A good latch may hurt at first for a few moments; a bad latch never stops hurting. Once that initial pain (if you experience that) has passed, a good latch doesn't hurt any more than a solid downward tug on your earlobe.

    I hope my frank descriptions aren't scaring you. My son and I went on to have a long (really, really long!), healthy, happy, rewarding breastfeeding relationship, and it was many times over worth the initial frustrations and discomfort of getting started breastfeeding.

    --Rebecca

  3. #3
    Join Date
    Jan 2006
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    863

    Default Re: ? - Breastfeeding with flat nipples

    Hi Alecia! Congrats on the upcoming delivery and new darling! Rebecca has given you great advice and I'm sure no one could guide you better as she's gone through it. I commend you on looking in to this early and being such a prepared mama! You're baby is so lucky to have you! Good luck and keep us posted!
    Kristie L.
    LLL Leader
    (the poster formerly known as fezzik812)
    Wife to Brett, Mommy to Seamus (5.1.05), and Emelie (1.18.08)
    "You must be the change you wish to see in the world."- Ghandi

  4. #4

    Default Re: ? - Breastfeeding with flat nipples

    Hi Alicia!

    It's so wonderful that you're taking the time to educate and prepare yourself for breastfeeding before your baby is born! You'll find that it will be very helpful in the early weeks of learning to breastfeed.

    Breastfeeding with flat nipples is absolutely possible and there may be a few things you can do to prepare in advance. Here is a great LLL resource:
    http://www.lalecheleague.org/FAQ/flat.html

    Good luck!
    Jen
    "Mothers are designed to be available to their babies--to help them make the transition into this big, wide world. To teach them to trust, and love, and feel good about being alive."
    --Elizabeth N. Baldwin, Esq., So I Nursed Him Every 45 Minutes

    Click here to find your local LLL Group
    How to tell if your breastfed baby is getting enough milk!

  5. #5
    Join Date
    Feb 2006
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    Default Re: ? - Breastfeeding with flat nipples

    Thank you all so much!
    Thanks for the first-hand advice Rebecca, it really helps to know what to expect, even if it means I'll perhaps need to do a little extra work
    Thanks for the link Jen, I found very helpful info as well.
    I'll get myself some breast shells asap, and will start with the exercises right away. The hospital I'll give birth in has lactation consultants available so I will ask for one to help me start off as soon as my baby is born.
    I will let you know how it goes, hopefully I'll have good news to share soon.

    Again, many thanks!

    Alicia

  6. #6
    Join Date
    Feb 2006
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    6

    Default Re: ? - Breastfeeding with flat nipples

    Great info I have flat ones as well and I was able to BF my children latching on was made easier with a nipple shield. I hated to part with that thing but we managed after a while they stick out a bit more. That and baby learns how to do it.

  7. #7

    Default Re: ? - Breastfeeding with flat nipples

    Good luck! Definitely get that LC to help you as soon as possible after the birth! A lot of mothers find that breastfeeding a baby helps the nipple to 'unflatten' as well--all the suckling breaks down some of the connective tissue that keeps it flat.

    Jen
    "Mothers are designed to be available to their babies--to help them make the transition into this big, wide world. To teach them to trust, and love, and feel good about being alive."
    --Elizabeth N. Baldwin, Esq., So I Nursed Him Every 45 Minutes

    Click here to find your local LLL Group
    How to tell if your breastfed baby is getting enough milk!

  8. #8
    Join Date
    Feb 2006
    Posts
    1

    Default Re: ? - Breastfeeding with flat nipples

    I am in the same situation. But I am now overdue for my baby (was due 3/3). I have been using something different than the breast shells. I have been using the Avent Nipplettes. They seem to be working. Worse case, they will help draw out the nipple right before I bf. My recommendation on them though is to have the stem of them point upward instead of down like in the instructions. When I tried them down, I lost the suction. When I have them up, it holds pretty much all day. I also use a breast pad over them to help conceal the little things.

    I used breast shells with my twin sons and it helped (but I didn't start using them until I had given birth and the lactation person gave them to me).

    Good luck with bf your little one!!! I'm sure you'll do great!!!

  9. #9
    Join Date
    Jan 2006
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    43

    Default Re: ? - Breastfeeding with flat nipples

    Alicia,

    While some mothers have found the measures discussed above to be helpful, most mothers with flat nipples do not need to do anything but breastfeed frequently and keep baby with them as much as possible in the early weeks. I can understand your worry, and I want to reassure you that your breasts were made for breastfeeding and they are up to the job! You and your baby, like all new nursing couples, will just need some practice to figure out what works for you both.

    The baby latches onto the areola/breast, not the nipple, so in most cases the shape of the nipple does not really matter that much. If the breast is kept nice and pliable from frequent nursing, it will make it easier for baby to latch on. Keep baby close to the breast almost all the time in the first week, to give him frequent practice. This advice is good for all moms who want to get breastfeeding off to a good start, no matter what their nipples look like.

    And worse case scenario, if he has trouble breastfeeding and doesn't "get it" in the first week, all is not lost! Line up a good LLL Leader and/or IBCLC (lactation consultant) in your community, because even with difficult starts most babies eventually figure out breastfeeding with mom's gentle persistence and encouragement.

  10. #10
    Join Date
    Jan 2006
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    Default Re: ? - Breastfeeding with flat nipples

    I just thought of a good analogy. Imagine trying to suck on a fully inflated beach ball. It would really be hard to maintain suction because it would keep popping out of your mouth. Now imagine if the beach ball were partially deflated (like a breast that is only partially full of milk) -- much easier to grab a big mouthful and suck. This is similar to a breast with a flat nipple; if the tissue is nice and elastic (not swollen or engorged) it should be relatively easy for baby to latch on. Some mothers have denser breast tissue; other mothers have more pliable tissue. Denser tissue can be challenging in some circumstances, but many babies do fine, especially if they get lots of practice.

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