I have been told that I have flat nipples. Can I still breastfeed?

Most women with flat nipples find that they can breastfeed with no problems without any special nipple preparation during pregnancy. In most cases, nursing itself causes the nipple to protrude more, but pumping can also be a help if the baby has trouble grasping the nipple. Talking with a lactation consultant about latch concerns before the baby is born, or having a LC observe latch at a feeding after the baby is born would probably be helpful.

My obstetrician has confirmed for me that I have inverted nipples. How are they different from flat nipples, and should I have any concerns about breastfeeding?

True inverted nipples only occur in about 5% of women, and are caused by adhesions that pull in the nipple. The "pinch test" is most often used to verify if nipples are truly inverted or just flat. When the area around the nipple is stimulated or pinched, the nipple inverts. In one study in 1992, there were four groups: one used shells, one used specific exercises, one did both, and one group was untreated. In this study of 96 women, the untreated group breastfed the longest. The results of that study lead me to wonder if the intervention of shell use erodes confidence in the breastfeeding mom who has inverted nipples.

One additional note of caution: because adequate stimulation is sometimes not achieved with inverted nipples, milk supply can be a problem, and moms should plan on good communication with a physician or lactation consultant and close observation for baby's healthy growth.