Operation Lactation

I have a confession to make: I had no idea how many different types of nipples existed until I began my career as a postpartum nurse. Let me just tell you, no two nipples are alike, even if they are on the same woman! I think that it is beneficial to have an appreciation for what you are working with nipple-wise. So let's learn!

When it comes to breastfeeding, nipples serve two primary functions: an outlet for breastmilk and a stimulus for baby's sucking reflex. Babies are born with a variety of instinctual reflexes, and one of those is a sucking reflex, which is stimulated when something touches the palate of baby's oral cavity.  When baby is successfully latched, your nipple will brush the roof of baby's mouth encouraging baby to suck. Milk will not start flowing until baby starts sucking, therefore, the nipple is quite important to this breastfeeding thing.

There are three different classifications of nipples, and we have "yarn boobie" here to take a look at the different types.

Everted

Basically, your nipple sticks out...all on its own. This type of nipple is the most straightforward when it comes to latching because it has the best chance of brushing against the roof of baby's mouth to stimulate the suck reflex. There are different tricks to get a nipple to protrude more, and many times breastfeeding and pumping will make your nipple evert more (even at its resting state). Although your breastfeeding adventure may not begin with everted nipples, you may end up with them.

Flat

In this case, the nipple does not protrude from the areola. Some nipples are classified as "mildly flat" meaning that the nipple does protrude slightly, but is not truly everted. An everted nipple can become flat due to pregnancy/postpartum swelling, but that will be a temporary situation. Flat and inverted nipples can pose a challenge to proper latching, but there are solutions and, as I mentioned, over time breastfeeding and pumping will usually help the nipple become more everted. 

Inverted

This type of nipple does not see the light of day, as it is pulled into the areola. Besides the basic latching difficulties, inverted nipples can also be more susceptible to damage. Because the nipple is usually protected by breast tissue it is extra delicate and when it is exposed to the powerful sucking forces of baby or a pump, the skin can breakdown. It is extra important to ensure correct latching and good nipple care to protect these nipples. 

There is another descriptor for nipples and that is retracting. When you squeeze your areola, the nipple inverts back into the breast tissue. Sometimes it is simply caused by breast swelling, but other times it is a result of tight muscle tissue in the nipple. It is not ideal for the nipple to disappear when baby is trying to latch, but like flat and inverted nipples this is something that can resolve or be worked around. 

Now regardless of the type of nipple, I believe that there is great power to be found in the "boob sandwich" so do not fret. As long as you utilize good positioning and remember My Latch Mantra you can achieve a good and comfortable latch. There are tools available that can assist in shaping the nipple, and something called a nipple shield can sometimes help achieve successful breastfeeding. Being aware of your particular nipple situation will help you and your lactation consultant troubleshoot and find solutions in the face of latch difficulties.

Be on the lookout for future posts that will cover the tools we can use to help solve latching issues related to nipples. Personally, I never like complicate matters unnecessarily by bringing in more equipment. So I would encourage you to start out using what God gave you, and if needed utilize the available tools.

Peace, joy and blessings!