If I have Flat or Inverted Nipples, Can I Still Breastfeed my Baby? 

There are many shapes of nipples; thimble shaped, rounded, pointy, flattened, dimpled, and truly inverted.  Most types of flattened and inverted nipples will not cause a problem during breastfeeding and if they do, there are ways to overcome them and succeed at breastfeeding. Babies feed from the breast not from the nipples – hence the term BREAST-feeding and not nipple-feeding. A breastfeeding baby draws the nipple far back into his mouth in order to suck effectively. Sometimes flat or inverted nipples can cause baby to have difficulty drawing the nipple deep into his mouth.

  Most babies at birth will begin to tug the nipple with their tiny fingers. In doing this they are elongating & stimulating the nipple, sort of preparing it for the first nurse session. They are usually very successful at getting enough nipple into the “soft pallet” of the throat.  Keeping your baby with you & allowing him to learn how to latch is done easiest before your mature milk come in.  When this still is not enough, other options need to be explored.

Listed here are a few:

1. Basic correct latch-on technique is very important. Making sure the baby opens very wide and takes in a large amount of the areola will provide a more comfortable latch.  These techniques can be learned at my breasefeeding class.
2. Massage Therapy to gently break-up binding tissues is an effective treatment for inverted nipples. This includes localized massage and manipulation of the constricted tissues at the base or areola area. Here’s what you can do. First, gently squeeze your areola until the inverted nipple ‘pops up’. Gently grasp your nipple, then with your other fingers target the areola area where you’ll gently but firmly pull down and then outwards in an action designed to place pressure on the underlying constricted tissues binding your areola. Your thumbs can balance the technique so that pressure is applied in a balanced manner.
3. Use an electric breast pump, or the Evert-It Nipple Enhancer just before feeding your baby. 
4. Wear  breast shells designed for flat or inverted nipples between feedings or for thirty minutes before feedings. Breast shells are made of plastic. They have two parts: a back with a hole through which the nipple can protrude and a rounded dome that fits inside your bra. Pressure on the shell from your bra against the areola gradually stretches out adhesions and allows the nipple to protrude. Be sure to wash these shells with soap and hot water between feedings and discard any milk that collects in them while you wear them in your bra. Note that shells come with two types of backs; the one with the larger hole is meant for treatment of sore nipples. Be sure to use the back with the small hole, which fits close to the nipple base.
5. Lastly, if your baby is still struggling to latch on, try a nipple shield. You can get these from a lactation consultant or breastfeeding counselor who will also guide you on how to use the nipple shield without compromising your milk production.