In keeping with the inverted nipple theme, I thought I would share this case study with you as it seems to be one of the more common struggles moms with inverted nipples encounter. The characters in this next Q&A are fictional but the problem very real.

Hi Geraldine,

I hope you can help me as I am at my wits end. Breastfeeding has been really tricky from day one as my baby struggled to latch onto the breast. This resulted in hours of frustration and a number of midwives trying to help my, all with different techniques and advice, unfortunately non of which resulted in baby latching onto my breast. As Luke wasn't feeding, I was advised to give him formula by cup feeding to protect his milking reflex, but the formula went everywhere and in the end, I gave in a offered him a bottle which he drained within minutes.

Feeling guilty for starving him, I decided to try him on the breast at each feed and then give him a bottle of formula afterwards. Luke manages to latch onto the breast, but then the breast quickly slips out of his mouth, so I know he is struggling to hold onto the breast during feeds. I have inverted nipples and was told I may not be able to breastfeed, but I am hoping that there is a way I could get around this.

I would also feel much happier if I knew that he was getting my breast milk instead of formula at each feed, instead of formula. My milk came in on day 3 and I was very engorged, which made latching on more difficult for Luke. Unfortunately, I am not sure whether my supply is still high enough to satisfy him if he were to ever latch onto my breast.

Please help.

Jenny.


Hi Jenny,

It is not easy to learn a skill if you don't have clear and effective guidelines. Breastfeeding is a learned skill and as we are all individuals, we each face different challenges when learning how to feed our babies. There are many moms who have been very successful at breastfeeding even with inverted nipples, so I would like to share some of the techniques we used to get those babies onto the breast.

Inverted nipples retract when pressure is applied to the areola, the darkened area around the nipple. When Luke latches onto the breast, he will apply pressure to the areola with his upper and lower gum and this causes you nipple to retract, making it harder for him to hold onto and milk the breast tissue. Often feeding him in the underarm position or rugby hold, with him lying on his back and coming up onto the breast is helpful as gravity will pull the breast tissue down and allow it to fall into his mouth.

If you have smaller breasts, this may not work for you as your nipples will point forward. You may find the use of nipple shields more successful, as the shield sits over the nipple and creates a firm teat for your baby to hold onto. Over time, the use of a nipple shield may help to stretch the nipple tissue and result in a degree of protrusion.

The other option you do have is to express and bottle feed your baby, as you currently are. Expressing will ensure that your breasts are well drained and this will protect or increase your supply as you creating a greater demand. Be sure to express both breasts every 3 hours from the beginning of one feed to the beginning of the next. This should synchronise your supply cycle with Luke's feeds, so that when you do offer him the breast, there is enough milk to keep him interested and focused.

With the increase of your supply, you may find that latching him onto the breast becomes a little trickier as your milk starts to flow and causes the breast to become slippery. Stay calm, place a muslin over the nipple and apply firm pressure with your hand, pushing into the breast. This will stop the flow temporarily.

I hope this helps.

Geraldine


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