This is a great post for anyone looking for ways to treat and relieve breastfeeding pain, or for those mothers who are worried about nursing while having inverted or flat nipples. I’m sharing my best tips and favorite products to help you out!
I breastfed both of my children past one year despite having inverted nipples and dealing with extended breastfeeding pain. While in the long run it was very fulfilling to me, it was also the BIGGEST challenge I had to overcome during those first precious months after birth. The utter exhaustion and lack of sleep was a close second. But I had at least felt more prepared for that. I was not however, prepared for the toe-curling pain, crying and self-doubt that came along with the initiation of exclusive breastfeeding.
Okay, so what does it mean to have flat or inverted nipples? As an example, when your nipples are hard they may appear to indent in, instead of pointing out like a typical nipple. Or when you pinch around the areola, they either stay the same or retract slightly in. Over a period of time, a nursing baby can eventually break the adhesions which pull this breast tissue in. You may not have “normal” looking nipples in the end, but they will indeed be functional.
If you are planning to breastfeed and have flat or inverted nipples, I can tell you this: YES! It can be done! Firstly, I always advise expectant mothers to do some research and seek out support before they deliver. Your hospital or birthing center will likely have a lactation consultant on staff but be sure to find someone you can meet with after you are on your own at home. Some consultants can come to your house, otherwise there may be La Leche League chapters who meet nearby on a weekly basis. You can also search for breastfeeding groups on Facebook and connect with other moms. Find out what you can before you are in the midst of the hormonal anguish called postpartum. And don’t be afraid to ask a professional specifically about your nipple issue. They are there to help and they too want you to succeed!
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In the beginning, latching will likely be an issue. Both you and your new little babe are trying to figure all this out so don’t be too hard on yourself and don’t quit right away! Here are some things you can try:
Get a deep latch
Forming your hand into a C-shape with your thumb above and your other fingers below your nipple, squeeze lightly and press back towards your chest to draw the nipple out. You can also manipulate your nipple by trying to pinch it into a more erect point beforehand as much as possible. Holding the baby with her stomach facing your own, support her with your hand on her upper back, neck and base of her skull. Don’t press on the back of her head as your bring the baby towards your breast. Brush the baby’s nose with your nipple and as she opens push your nipple in towards her top lip, aiming for the roof of the mouth. Imagine it like your nipple is flipping in past her front gums and far back into her mouth. You want the baby’s lips flared around the areola and for her to be taking as much nipple as possible into the mouth.
Use some tools
A nipple everter
A nipple everter looks like a breast pump flange with a blub at the end. You use it to draw out the nipple before feeding. You can find these on amazon but the selection often varies. You can also use a hand pump. This is the one I used and I’ve always found it to be easy to operate and effective. These haakaa hand pumps are also great and very easy to clean. You use the hand pump in the same way to draw your nipple out into some semblance of a point before baby latches. Also, once your are engorged, it’s helpful to pump off some of that watery foremilk and soften the breast for an easier latch.
Breast shells are made of plastic and/or silicone and are worn inside your bra. They are a small cup with a hole for the nipple to protrude through which prevents moisture from being trapped when your nipple inverts again. If you are sore from nursing they can also help in keeping fabric away from rubbing on your poor, tired nips. I have used this brand. I do feel they are beneficial but as a word of caution, overuse, or wearing them with a bra that fits too snug can potentially lead to clogged ducts. They also cause more leakage as they are always pressing on your breast. If you are diligent about it and you have the right type of shells, you can save this leaked milk for a later bottle feeding. Breastmilk is good at room temperature for at least 4 hours. I would wear my shells between feedings and empty them into a storage container at the next nursing session.
A nipple shield
A nipple shield can be a life saver. Or so I’ve heard, as I was never very good with using these. Go with your lactation consultant’s advice on this one and be sure to have someone instruct you on the best way to put it on. Buy one, such as this Medela brand, and bring it with you to the hospital.
Don’t try wearing breast shells or any other nipple everting device during pregnancy as nipple stimulation can potentially induce labor. Also, you DO NOT need to “toughen up” or manipulate or nipples in any way to prepare for breastfeeding. This can cause unnecessary soreness and potential damage. When your baby is born, you’ll be learning all this together. Many mothers experience some form of pain when they first begin breastfeeding. Your journey just may be a bit of a bumpier ride and that’s okay.
And finally, be sure to take care of those tatas! Lanolin always worked the best for me. But also some plain old coconut oil can do the trick. If you prefer an organic brand of nipple cream I went with Mothers Love nipple cream. I would nurse my baby and let some expressed breastmilk dry on my nipples. Then apply the ointment of choice and either wear my breast shells or just walk around topless. Another great way to find relief is with gel pads. The Ameda Hydrogel are the best, but Lansinoh and Medela also make a version of these that are less expensive. Don’t hesitate to ask for a pair from your nurse at the hospital. Score an extra pack or two if you can. You can rinse them and store them in the refrigerator on and off for a couple of days. A chilled gel pad is the ultimate boobie relief.
I always kept a basket of supplies close at hand during my nursing sessions. You can check out this post on how to create your own “breastfeeding basket.”
You are likely going to be very sore for a while. Possibly even cry-every-time-they-latch sore. (However, if this intense pain continues throughout the nursing session and not just at the beginning, this may be a sign of a bigger problem.) I remember standing in the shower with my hands over my breasts because I couldn’t even tolerate the water raining down on my poor, raw nips. With my first born it was a full seven weeks before I was nursing without any pain. The second time around it took about a month. But then we nursed past 14 months and 12 months respectively and even though the beginning was rough, we made it! And you can make it too (if you choose to). Everyone is different and so is every baby. The bond you forge from breastfeeding your sweet babe is so special and to me it was worth the sacrifice.
If your pain continues or becomes unbearable, be sure to seek further help and find a way to give yourself a break. You can pump or hand express for a day, or even for just one feeding a day. I will tell you, seven weeks is not your standard break-in time and we had some other “issues” that you can read about here. In the end, how you feed your baby is YOUR choice. I just want you to know that there are resources and support out there to help you make the best decision for you and loved ones.
I am not against formula and in fact, I did supplement towards the end with my second born. We tried to with my first because he needed the calories, but he ended up refusing bottles completely. If you need to supplement, try to get advice on how to do so from more than just your pediatrician. A lactation consultant will be able to give you a solid plan to ensure you continue to maintain your milk supply.
Dealing with breastfeeding pain is tough, but with proper guidance and support, continued (even extended) nursing is totally achievable!