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Here’s How Inverted Nipples Can Affect Breastfeeding

There’s a lot of confusion surrounding whether inverted nipples can affect breastfeeding, which makes sense—both breastfeeding and nipples can be confusing. Some nipples point out from the breast, some are inverted and pulled into the breast, and still others are somewhere in between, lying flat against the breast.

The good news is that no nipple shape automatically makes breastfeeding off-limits.

Inverted nipples are totally normal and, in most cases, are just something you’re born with.

While it’s more common to have nipples that are outies rather than innies, having inverted nipples doesn’t mean anything is wrong with you, Dennis Holmes, M.D., breast cancer surgeon and researcher and interim director of the Margie Petersen Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. Most often, it’s just how your nipples are (like boobs, nipples can be diverse in some pretty fascinating ways, including how they rest on your breasts). FYI: “flat” nipples aren’t necessarily inverted. Flat nipples will occasionally still protrude out when stimulated or cold (you can try lightly pinching the areola or standing in front of a freezer topless to test it out), while inverted nipples will pull into your breast.

Inverted nipples happen when skin at the base of the nipple attaches to surrounding breast tissue, Dr. Holmes says. Some people are born with inverted nipples, while others may develop them during puberty as their breasts grow and change. It’s also possible to temporarily have inverted nipples after breastfeeding due to inflammation in the milk ducts that pulls nipples inward, Dr. Holmes says. You can even have one nipple that’s an innie and one that’s an outie. It’s all normal and healthy.

That said, if you’ve always had nipples that pointed out and suddenly they start going in at any point after puberty, it’s time to see your doctor. Nipple retraction could be a sign of breast cancer because a tumor in the center of the breast can shorten milk ducts, making the nipple turn inward, says Dr. Holmes. It’s not a reason to immediately panic, but it is a good reason to check in with your doctor.

Unfortunately there is some truth to the rumor that inverted nipples can make breastfeeding harder.

But don’t worry—it’s not impossible and it does typically get easier with time, Leigh Anne O’Connor, board-certified lactation consultant and La Leche League leader, tells SELF.

Depending on how inverted your nipples are, they might actually come out once you start breastfeeding (you can thank the suctioning power of your baby’s mouth for that). They might stay that way, too. “In some cases breastfeeding helps the nipple to stay everted even after weaning and other times the nipple inverts again after weaning,” O’Connor says.

Even if that happens, breastfeeding with inverted nipples can still be “challenging” in the beginning, O’Connor says. The baby actually needs to latch onto your areola (the skin that surrounds the nipple) and should bypass your nipples entirely, so it’s not like your nipple has to protrude for milk to emerge. But it might still be unpleasant because your skin needs to stretch to accommodate nursing. And, since inverted nipples are attached to the surrounding breast tissue, they may hurt and bleed a bit when they detach and protrude, O’Connor explains. While this obviously won’t feel good for you, it shouldn’t cause nursing problems, she says.

If you have inverted nipples, there are some things you can do to make the breastfeeding process easier on yourself.

Sometimes you can manually pull your nipple out to make it stick out, O’Connor says, adding that some people find that pumping helps with this. Using a nipple shield, which is a thin, soft, silicone cover that goes over your nipple and allows milk to flow to the baby, can also help the baby latch on better.

If you have inverted nipples and you’re worried about your ability to breastfeed, talk to your doctor. They should be able to give you tips in advance of giving birth that will make the process easier. And if the above methods haven’t helped solve breastfeeding issues you suspect are due to inverted nipples, talk to your child’s pediatrician or see if you can find a certified lactation consultant near you.

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