FLAT NIPPLES

This generally poses a problem during breast-feeding. A woman may produce enough milk but due to flat nipples the breasts feel full, heavy and painful. As a result the baby is not able to suck enough milk and remains hungry and cranky. The management of flat nipples – however much engorgement contributes to the problem, is:

• Try to manipulate the nipple a little, to make it more erect and easy to grasp.
  
  
• It is often helpful to remove some of the milk so that the breast becomes a little softer – you can either express by hand or use a breast pump.
  
  
• Gently and patiently, put the infant to the breast for another try. One drop of milk left at the tip of the nipple may act as ‘appetizer’.
  
  
• Remember that the nipple and the areola (the dark skin round the nipple) must both be put well into the baby’s mouth. Sometimes to do this you have to press the baby rather firmly on to the breast. Don’t be afraid to do this – if you think the breast is going to block the baby’s nose, use a finger to hold the breast clear of the nose – don’t pull the baby’s head away!

If the baby still does not succeed let it suck through a nipple shield for a few days, until engorgement subsides and the nipple has stretched.