This is a series breaking down the myths and truths about breastfeeding challenges. There are a lot of barriers to breastfeeding happening on a larger scale. Check out this article from Pathways about larger systemic barriers. I want to break down things a little different, on a smaller scale. Let’s start with something that might seem straightforward, nipple shape and size.

Does it matter what your nipples look like if you want to breastfeed? Can you breastfeed if your nipples are… Thick, thin, flat, inverted or pierced? Nipples, just like breasts and areolas, come in all shapes, sizes and colors.

When a baby breastfeeds, they take the nipple, areola and breast tissue deep into their mouth. They stretch the nipple to twice its original length to get it to the spot between the hard and soft palate (roof of the mouth), then use their jaw and tongue to keep it in place while they suck and swallow.

The MYTH: My baby won’t be able to nurse if my nipples are flat or inverted.


This is a flat nipple as seen with the pinch test. Do not use without permission.

Truth: Baby’s BREASTfeed not nipple feed! So yes, as long as baby is able to get a mouth full of breast, what shape and size your nipple is shouldn’t matter. You might need patience and help in the early days to support baby getting a deep comfy latch, which I think is common overall. Support your baby while they figure out latching and breastfeeding by being skin to skin as often as possible in the early days.

If you want to see how your nipples protrude, or evert, you can do the pinch test.

Take Home Tips: Taking a baby led, mother guided approach to latching will make sure to protect your nipples and respect baby’s instincts to breastfeed. Let baby guide when to eat, then you can play with what positions work best for your comfort (many find the laid back position very helpful in getting baby to take a lot of breast in, while others find they need to use the clutch or football hold in order to have more control over breast support).

This 2 week old baby is enjoying milk in a laid back position. Mom is supporting baby's neck and back. Do not replicate without permission.

This 2 week old baby is enjoying milk in a laid back position. Mom is supporting baby’s neck and back. Do not use without permission.

There are techniques to support comfortable latches with a variety of nipple shapes and sizes. Two techniques that can help are everting the nipple prior to feeding (by gently rolling the nipple in between the thumb and index finger, or using a breast pump), and pulling back on the breast tissue during latch on. Also helpful can be making sure the nipple is fully dry after a feed and use lanolin in the early weeks to prevent damage.

The MYTH: If my nipples are/or were pierced or are thicker I won’t be able to breastfeed.


This nipple was previously pierced and is thicker due to scar tissue. Do not use without permission.

Truth: If your nipples were pierced (at least over a year ago) and have healed, nursing is usually no big deal. Typically it is recommended to remove piercings before the 6th month of pregnancy. Studies have suggested piercings could decrease supply due to damage or obstruction to the milk ducts, or excessive leaking out of the piercing holes. By being aware of baby’s growth by nursing often and watching output you will know if you need more support.

Thicker nipples (sometimes referred to as fibrous nipples) are a variation of normal. Also, scar tissue from a pierced nipple or surgery can make a nipple thicker. They are usually only challenging if baby is very small, or has oral issues such as tongue tie. In most of these cases simple techniques to support the breast during feeds is sufficient until baby grows.

Take Home Tips: Most decide to remove the jewelry for the breastfeeding period, instead of taking it in and out for feeds (constant removal also increases risk for infection). You can use a ‘taper’ in between feedings if you wish to keep the hole open.

Spending time around other nursing families will show you a wide variety of breast and nipple shapes sizes and colors. I encourage you to connect to other nursing families before you start your own breastfeeding journey. You can look up a La Leche League meeting near you. Stay tuned for the next in this series where I’ll look more at health issues that affect (or not) breastfeeding.

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