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Inverted Nipples and Breastfeeding

Inverted Nipples and Breastfeeding: What All New Moms Need To Know

Until you got pregnant, delivered, and chose to breastfeed, you probably weren't even aware that your nipples were inverted. After all, breasts can have protruding, flat, or protracted nipples, and inverted, or invaginated, nipples aren't so uncommon that you had any reason to think it was even an issue. It's just another way that some women's nipples look, you may have thought. And, about 20% of women are born with inverted nipples, so one in five new Moms considering breastfeeding must face this. Otherwise, it's not an issue. At all.

Inverted Nipples? You Probably Didn't Even Notice

And, many younger girls who have not yet reached puberty often have inverted nipples that begin protruding only once hormones start circulating, and so there's a good chance you've seen inverted nipples before, and thought nothing of it. Only now that you're choosing to breastfeed are you finding that it's even a "thing." In reality, it's often not a big deal, or anything to even think twice about. In the majority of cases, there are absolutely zero health implications.

The reason for inverted nipples may, in rare instance, be due to a health issue, but they can also occur after sudden and significant weight loss due to dieting. But for the majority of women with inverted nipples, it's not a sign or symptom of anything amiss in the body, so don't start worrying needlessly; some women are just born this way. If you were born with inverted nipples, it's considered congenital inversion. However, if your formerly protruding nipples suddenly become inverted, and you haven't lost weight, there is the possibility of a health issue causing the condition.

Please don't get scared, as the majority of the time invaginated nipples are not a cause for concern. However, for the sake of completeness, here is a list of health conditions that might cause this condition:

Inverted Nipple Causes

trauma to the breast tissue, either from surgery or anything else

breast cancer

breast infection

inflammation of the breast tissue

gynecomastia (only in people born as male)

systemic infections, including tuberculosis

Am I Disfigured?

Are inverted nipples a disfigurement? Hardly. It's just one of the many physical differences among people. In fact, both men and women can have inverted nipples. Just likehow some people have black, red, brown, or blonde hair. Humans have a great deal of variation in their appearance, and this is just another aspect of that undeniable reality. People come in all shapes and sizes, breasts come in all chapes and sizes, and this is true of nipples as well. It's not a birth defect, merely another way in which people differ from one another. It's really nothing at all to be ashamed of. Like a belly button, a nipple may be an "innie" or an "outie."

The condition is often caused by adhesions at the base of the nipple, or connective tissue that holds the nipple in the inverted position. The connective tissue can be stretched, and adhesions can be broken up by <<> You can begin self-massaging your breasts and nipples during pregnancy, or you can seek out a professional massage therapist versed in the technique.

Know that some studies, as well as traditional women's wisdom, suggest that nipple stimulation can help ripen and dilate the cervix due to a sharp rise in oxytocin, and thus can be utilized as part of an <> in low-risk first-time pregnancies. Therefore, limiting stimulation of the nipples and breasts to after you've already given birth might be the most sound choice, whether you're doing self-massage or seeking the help from a trained expert.

There's no definitive proof that this is a risk, but tradition suggests that too much nipple stimulation can lead to premature labor. Our advice? Heed the wisdom of countless generations of women who have come before. They didn't rely on placbo-controlled double-blind studies, yet managed toimpart volumes of knolwdge on pregnancy and childbirth. So take traditional wisdom and give it due consideration, always.

Nipple Inversion Is Graded According To Severity

In a medical setting, nipple inversion is graded into three distinct classes, dependant entirely on how difficult it is to get your nipples into an everted, or protruding, position. In reality, there are no hard and fast rules, and so there's a small bit of subjectivity involved, on the part of the health professional making a diagnosis.

Grade 1: The nipple can easily be protracted and stays visible. Of course, this will not affect breastfeeding.

Grade 2: The nipple comes out, but only with a bit of difficulty. And, the nipple retracts. This may affect feeding.

Grade 3: The nipple cannot be pulled out and stay out. After pressing, the nipple immediately retracts again. Direct feeding may be difficult, and in some rare cases, impossible.

Surgery For Inverted Nipples: Is It Necessary?

You may be wondering, if this is a normal condition, why so many women opt for corrective cosmetic surgery. Some women really don't like how it looks. And, that's fine, however we would always consider self-acceptance the best stance regarding our bodies. Any surgery that can be avoided, should.

However, if a woman is severely self-conscious about her inverted nipples, surgery is, in fact, an option. Be forewarned, however, that the results aren't always what you're expecting. Ask questions, if you're thinking about surgery. You may choose to keep your inverted nipples, as it's an aspect of your uniqueness that makes you different. It's all how you look at it in the end.

Some women go for surgery because they have been (erroneously) informed that inverted nipples will be a hindrance for breastfeeding. True; it may create challenges, but it isn't anything most women cannot overcome with a little bit of effort, and sometimes help from an inexpensive device. There are severe cases, in which surgery might be advisable, but remmeber to always get a second opinion before going under the knife.

Of course, a surgeon will try to perform the surgery so that the outcome will leave you with sensation in the nipple, without visible scarring, and most of all, to ensure that the milk ducts will remain functional. As with all surgeries, there is a risk involved, and everything may not go as planned.

Some surgical technqiues are better then others. < ahref="" style="color: black;">The trampoline repair is one of the safest and quickest techniques, with little scarring, detailed in an abstract by Ali Soueid and Ali Juma of the Department of Plastic and Reconstructive Surgery, Countess of Chester Hospital, UK.

You could also pierce your nipples, if you're into that sort of thing. Of course, this is not every woman's style. If your nipple can be even temporarily protracted, it can then be pierced, and the piercing keeps it locked in a protracted position. Over time, this will even stretch the underling connective tissue that had kept your nipples hidden, so when the piercing is removed, the nipple remains in view.

Can I Breastfeed With Inverted Nipples?

Short answer: Yes. Long answer: Yes, but you will likely have to make accommodations. Some women, during pregnancy, find that their inverted nipples begin protruding. In such instances, nothing at all needs to be done. After you're done breastfeeding, your nipples may return to their protracted position, or they may continue to protrude. Again, this is all highly variable, and there are no set answers.

Some women find that with stimulation, even a severely invaginated nipple will protrude temporarily, remaining erect enough for your baby to feed without any trouble. If this describes your nipples, chances are they will not present any issues when it comes to breastfeeding. Simply hand-express milk from the breast before trying to get your little one to latch. It can be that easy.

Some suggest applying ice to the nipples to help them protrude. Be forewarned, however, that while this may be effective, applying cold compresses to the breasts is the traditional way to stop milk flow, and so this tactic may interfere with milk let-down.

But what about if your nipples have not shown themselves, even after giving birth and ample stimulation? Is it too late? Will your baby be consigned to an infancy of inferior formula feeding? Should you be kicking yourself for not opting for surgery, when it was still a viable option? Not necessarily. Even if your nipples do not protract after giving birth, don't worry. All is not lost.

Firstly, correct latching means the baby is engaging the areola, and not the nipple itself. This is a common misconception among women who have not researched the topic, nor availed themselves of lactation counselors. href="">Like le leche league international says, "Remember that babies BREASTfeed, not NIPPLEfeed."

But there's more you can do, if that's not working. A lot more.

Pumping immediately before a feeding session with your infant can help. Of course, breast pumps with more power, such as the electric models used in hospitals, work best. Not all pumps are created equal, and a pump with a weaker suction may not be effective. Be sure that you use the proper nipple shield for your nipple size, else you WILL experience pain during use.

There are even inexpensive suction devices that you can use before, and between, feedings to help withdraw the nipples. A disposable syringe, sans needle, can even do the trick. And, after some time, the suction can help free the nipples from the web of connective tissue keeping them withdrawn.

Breast shells, which are both uncomfortable and annoying, have been found to be less-than-effective solutions in some studies. Still, many new Moms swear by them. These are plastic inserts you wear in your bra. You can begin using shells during pregnancy, and can continue after giving birth, wearing the device for about a half-hour before feedings.

Another method is to pull back on the breast tissue while the infant latches. It works like this: As you present the breast to your baby, you're already supporting it with your hand. All you have to do is modify this slightly, using your thumb on one side, and your other four fingers on the other, to pull the breast back, toward your body, while the baby latches.

Reverse pressure softening is another method that requires no additional equipment, just a bit of effort. Make an "A-OK" symbol (in the 1980s this was also the symbol for BS!) with your fingers. This means that your thumb and pointer finger make a circle. Take this circle of fingers and place your nipple in the center. Now, press for a few minutes toward your body. This also works for some women, and is relatively easy to do.

Nipple Shields are probably the best known solution, but it's only advisable to use one that has been properly fitted, with the guidance of a lactation counselor. It's a piece of flexible silicone that looks like a nipple and is placed --you guessed it -- over your own nipple.

You can even use more than one solution simultaneously, but it;s suggested keeping notes, so you can go back and see what works best.

How Do I Know If My Nipples Are Truly Inverted?

That's where the pinch test comes in. It'd very easy, and you'll know for sure without having to visit a doctor. Simply compress the areaola, an inch from your nipple on both sides you're pinching from. If your nipple does not protrude, your nipples are flat. If your nipple actually becomes more concave, your nipples are "shy"and you have inverted nipples, for sure.

Where Do I Begin?

Start with testing your nipples to see if they are, in fact, truly inverted, and to what extent inversion may be present. From there, read more about each of the techniques detailed in this article. Usually, it's easiest to start with those methods that require nothing other than your own hands. From there, branch out to more complex solutions. You may want to have nipple everters, nipple shields, and a good quality electric breast pump on hand before delivering your newborn.

That will take the stress out of the equation, as waiting for a nipple shield to arrive in the mail can waste valuable time, and interrupt your cycle of milk production. In the end, do what works best for you. You may want to speak with a lactation consultant before baby arrives, so that you will be prepared and know where you stand.





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