Tell me everything I need to know about nursing w/ flat or inverted nipples

[gingerbane]

Hey ya'll,

I want everyone who can to tell me everything I need to know about nursing with flat or inverted nipples. I know I have one or the other (not sure which) and I won't really have access to anyone who can help me with nursing questions or problems when the baby is born. So, lay it on me!!

[Nora'sMama]

I had flat/inverted nipples...which I confirmed by doing the pinch test described on a fact sheet from LLL. I pinched them and they went *in* instead of out. I figured this out at about 8 months pregnant. They looked like "normal" nipples to me, so I had never suspected flat/inverted nipples until I saw the sheet and decided to try it!

I asked the LLL leaders of the group I was attending if there was anything I should do before the baby was born, to help prepare my nipples. The things I had read on the internet mentioned using breast shells (I believe Medela sells them) to draw out the nipple. The LLL leaders said that this was not necessary, so I didn't do it.

My dd *did* have issues latching. I don't know how big of a factor my nipples were and how much other issues contributed. At any rate, on day 3 of really no latching to speak of we started with a nipple shield (also made by Medela - Target sells them) and used that, on the advice of a lactation consultant. She warned me to start "weaning" dd from the shield as soon as possible, as there is the possibility that a) the baby will come to only be able to nurse from the shield long-term, which is a PITA and b) the milk supply *can* be affected.

So, after a few days of nursing really nicely with the shield, I would just feed her a little with it and in the middle of a feeding (when she was no longer quite so hungry) I'd try the naked boob. We did this more and more until one morning (she was not yet 3 weeks old) I just bit the bullet and decided to work with her and see if she could BF without the shield. It was a little stressful and her latch was not "textbook", but she did it. She is still nursing almost 2.5 years later! Yay!

Anyway, I don't know why you won't have access to nursing help after the baby is born, but that is worrisome. Besides flat/inverted nipples, there are many other common issues that could come up, and it's really important to have support and good advice. Kellymom is great, and you can call 1-800-la-leche to find a local number to call a LLL leader, but if you can line up an IBCLC that is obviously the best.

I read at least 2 BF books and millions of Kellymom pages and links and attended LLL meetings regularly before my dd was born, and I still REALLY needed help. Some women don't. My mother infuriated me on about day 3 (I was crying, trying desperately to get dd into position to nurse) by saying, "when I breasfed you, I just put you to my breast, I didn't need any fancy Boppy pillows or anything." @@ Well, I do hope you are that lucky!! But, in case you aren't, you need a game plan. Asking for advice on the internet is OK if there is really no other option, but it is really impossible to know *precisely* how best to advise someone if you are not "on the scene", so to speak.

I had many loooong conversations with a LLL leader and she was GREAT but what really ended up helping me be successful was the LC observing me try to breastfeed.

However, again, I don't know your particular situation so I am really not trying to make you feel bad if you are in Siberia or something and really have no access to an IBCLC. There are obviously many great resources, like this board, that you can still access. The thing with breastfeeding is that it is trial and error. And a board like MDC with so many different women posting on it will have lots of great suggestions for you to try, if you do run into difficulties. I wouldn't assume that will be the case simply b/c your nipples are flat or inverted, but it might not be a bad idea to get some nipple shields just in case. (I tried e-verting the nipple myself, of course, but dd would not latch onto it - the shield was really a miracle for us! but, many women with f/i nipples won't need it. It's kind of an insurance policy!)

Best of luck to you.

[Nora'sMama]

OMG, I'm cracking up - I looked at your other posts to see what your situation might be (sorry about being nosy ) and I wasn't far off with my Siberia comment! So you're in China. Well...I think you can order the Medela shields from the Medela website. Sorry I have to run right now and can't get the link for you but probably Medela.com! I would also check out what Kellymom and the LLL site (llli.org) have to say about flat/inverted nipples. One encouraging anecdote for you: my cousin did not bf her 1st ds b/c she had inverted nipples and thought that meant she could not bf. Well, she learned differently while pg with her 2nd ds, and nursed him 15 months! Not sure if she had to use a shield or not...I think she may have used the breast shells (shells and shields are different!) to draw out her nipples.

I know you will get more great advice from other posters.

[sheilajolene]

I didn't know I had flat nipples (they don't look it!) until ds was 10 days old and extremely malnourished (my midwife kept saying he was a great nurser, but he'd lost nearly 20% of his birth weight at that point and even more within the next few days. I wish she'd lose her license. Anyway...) I finally saw an LC who gave me the medela shield. I hated using it, but I wouldn't have been able to nurse without it. DS weaned himself off of it at about 2 months. I used to use it for the first half of the nursing session and then remove it once my nipples were ready. I also pumped every few hours since he'd lost so much weight, and I think the pumping really helped my nipples become breastfeeding-friendly, so-to-speak.

Good luck, I really hope that it goes smoothly.

[Bellejar]

flat nipples

If you don't get your hands on a nipple shield I had luck just using my hand to shape the nipple when first getting your child to latch - I had to do this while I was nursing for the first 3 or 4 weeks. After that my nipples changed completely. Oddly I didn't have a problem with my second daughter latching only my first. My nipples look completely different after nursing 3 + years though and I only had a 12 week hiatus between my two children and it looks like I will have about the same before my third.

Be prepared for pain in the beginning, I would also make sure you have 100% lanolin on hand to treat any issues! Good luck!

[Breastfeeding Insomniac]

The most important thing to know is that it is totally and 100% possible to successfully breastfeed w/ flat/inverted nipples. Just remember, the nipple is more of a target for giving baby a guideline of where to start to latch onto, ithe the ducts around the nipple, in the areola that baby gets the most milk from. Here are some links to info that may help you:

http://www.breastfeed-essentials.com...ednipples.html

http://www.breastfeeding-basics.com/...inverted.shtml

http://www.medela.com/NewFiles/flatinvnips.html

http://www.llli.org/NB/NBMayJun03p93.html

http://www.llli.org/FAQ/flat.html

[pixiemammy]

I have (well had ) flat nipples & got engorged at the start so it was a bit of a struggle. I had tried the hoffmann technique while pg & DH helped too , but they were still flat when DD arrived.

A midwife showed me how to make a "nipple sandwich" to help DD latch on. We didn't need shields.

I will say that it was very painful for the first while, some people reckon that adhesions inside the flat/inverted nipple stretch and break to enable it to come out. I found the whole "It shouldn't hurt unless you're doing it wrong" argument very disheartening, because we weren't doing it wrong, I got her latch checked plenty of times, my nipples just needed time to get into the swing of things.

Anyway 11 months down the line, DD's still feeding happily. I stopped doing the nipple sandwich thing months ago and I am the proud owner of not-flatties now It took a good few months for them to stop being flat with DD feeding on demand, so I don't think, in retrospect that the hoffmann technique would have worked on them even if I'd done it for a few years!

So, it's very possible to have a wonderful nursing relationship with flat nipples and infinitely rewarding when you get it all sorted! Best of luck x

[lemon]

I would definitely order the nipple shields, so you have them on hand. They were what worked for us (flat nipples) for the first couple of months. Anything like that that you *might* need, I would just get, since you can't just send dh to the store for things. Breast pumps can help too, since the suction helps pull the nipple out. I would definitely get a good electric one, in case you do have problems, so that, worst case scenario, you can pump for the baby while you are working out your issues. Since you probably can't just go rent one if needed. (I did use one for ds, before we figured out the nipple shields. Just for a day or two; we used a syringe to get the colustrum in his mouth. And I had midwife support.)

Also, there is LLL in China. I googled really quick and pulled up a website for Shanghai. I think there is one in Beijing also. Even if you don't live in one of these major cities, you can at least try to get in touch with a leader who is so that at least you have some resources in your own time zone. Over the phone help is nice, even if you can't meet with a lactation consultant in person.

Also, can you find the expat moms in your town? At least having a friend or two with nursing experience would help. There are a zillion international schools in China with teachers who are parents, for example. Networking before you have kids is hard, but maybe possible?

My sister lives in China, so I don't really think it's that remote, but it does have its own set of challenges.

[lemon]

LLL China