Breastfeeding With Inverted or Flat Nipples: What Helps

Maybe you noticed during pregnancy that your nipples point inward or barely stick out, or someone mentioned it at a checkup. It’s natural to worry that your baby won’t be able to latch.

Here’s the reassuring part: babies don’t feed from the nipple alone. They take a big mouthful of breast tissue, and a good latch can work around many nipple shapes. With the right start and some practical tricks, most babies get there.

Flat vs. inverted nipples: how to tell

Cleveland Clinic estimates that about 10% to 20% of people have flat or inverted nipples, and most are born that way. It’s also normal for one side to differ from the other.

• Flat nipples don’t stick out much at rest but extend when touched, cold or stimulated.
• Inverted nipples sink inward or look tucked into the areola.

La Leche League GB suggests a simple pinch test: put your thumb and finger on opposite sides of the areola and squeeze gently inward. A nipple that moves outward is protractile. One that stays flat or pulls inward is flat or inverted. La Leche League GB notes most nipples that look inverted at rest come out when stimulated, and truly inverted nipples that can’t protrude at all are rare.

Breasts can also change after birth. Swelling from engorgement can make nipples temporarily look flatter, and this usually settles as the swelling goes down.

One important exception: if a nipple that used to stick out has recently turned inward, especially on one side or with a lump, skin changes or discharge, see your doctor. Cleveland Clinic notes a new inversion can sometimes signal a condition that needs checking, including breast cancer.

Do you need to do anything during pregnancy?

Probably not. La Leche League GB says there’s no evidence that treating nipples in pregnancy helps, and research hasn’t shown clear benefits from breast shells, nipple exercises or devices. Being labeled as having “difficult” nipples can also knock your confidence.

More useful steps before birth:

• Learn the basics of latching and positioning
• Learn hand expression, so you can collect milk if your baby needs time to latch
• Line up help, such as an IBCLC or La Leche League leader, for the first days

Getting started after birth

Begin with skin-to-skin

La Leche League GB calls skin-to-skin contact as soon as possible after birth the best way to get breastfeeding started. Your baby’s instincts to root, lick and nuzzle help the nipple respond.

Try a laid-back position

Recline comfortably with your baby on your chest. Gravity holds your baby close and lets them lead, often with a wider mouth and deeper latch. Side-lying positions can help too, Cleveland Clinic notes.

Aim for a deep latch

Wait for a wide-open mouth and bring your baby to the breast so they take in plenty of areola, not just the tip. Our guide on how to breastfeed walks through the steps.

Shape the breast

A “breast sandwich” helps: compress the breast gently with your fingers in line with your baby’s lips, like holding a sandwich to take a bite. This gives your baby more tissue to grasp.

Tricks to draw the nipple out before a feed

These are worth trying right before you latch your baby:

What to try	How
Rolling and cold	Gently roll the nipple between thumb and finger, or touch it briefly with a cold, damp cloth.
Reverse pressure softening	Press fingertips gently around the base of the nipple for about a minute to move swelling away, especially when engorged.
Pump first	Pumping briefly before a feed can draw the nipple out and start the let-down.
Nipple everter	Small suction devices (bulbs, soft cups or syringe-style) pull the nipple out just before a feed. Follow the maker’s instructions.
Hoffman technique	Place thumbs on either side of the nipple base, press in and pull them apart. Cleveland Clinic lists it; La Leche League GB notes the evidence for it is weak.

Some people use breast shells worn inside the bra. La Leche League GB cautions they may raise the risk of mastitis, so if you try them, limit them to about 30 minutes before a feed and throw away any milk that collects in them.

If your baby can’t latch yet

Don’t panic. Many babies need a few days or weeks to work it out.

• Protect your supply. La Leche League GB suggests expressing 8 to 12 times in 24 hours until your baby is feeding well at the breast, by hand or with a pump.
• Feed your baby your milk. Expressed milk can be given by cup, spoon or syringe. In the first days, small amounts of colostrum go a long way.
• Consider a nipple shield. A thin silicone nipple shield can help some babies latch. Get help with sizing, and check your baby is feeding well and gaining weight while using one. Most babies can move off it later.
• Look at other causes. Prematurity, a sleepy baby or a tongue tie can add to latch trouble. The NHS lists difficulty latching and staying on the breast among the signs of tongue tie.

Caring for your nipples

Some tenderness in the first weeks is common while you and your baby learn. Pat your nipples dry after feeds, change damp pads often and consider a simple barrier ointment. Pain that lasts through feeds, cracks or bleeding mean the latch needs checking. See our guide to sore nipples for more help.

When to get help

Contact a lactation consultant, your pediatrician or your doctor if:

• Your baby can’t latch or stay latched after the first day or two
• Your baby has fewer wet or dirty diapers than expected, or isn’t gaining weight
• Feeding is very painful, or your nipples are cracked or bleeding
• You have a hot, red, painful area in the breast or a fever
• A nipple has newly turned inward

Our breastfeeding support page lists where to find an IBCLC or La Leche League leader, and the Common challenges hub covers other early breastfeeding problems.