For a long time now, women with flat and/or sunken nipples, also called inverted nipples, are no longer recommended to prepare them during pregnancy for breastfeeding. Dr. Sarah Vega, pediatric neonatologist, and coordinator of the Breastfeeding Unit of our clinic, clarifies some doubts on this subject.

1. Examination of the nipples to define if they protrude normally, that is, if they protrude from the breast upon observation alone, should be performed during gestation. Most women have this type of nipples. There is another type of nipples, those that appear flat but when stimulated with the fingers immediately protrude. Only a small percentage of women have true flat and/or sunken nipples.
2. Flat and/or sunken nipples require special techniques so that the baby can form them in a few days and the mother can breastfeed successfully.
3. In these cases, an appropriate technique is used to hold and offer the breast to the baby as soon as the baby is born to facilitate latch-on. This is a very effective procedure.
4. In exceptional circumstances, an additional resource can be used: a plastic artificial nipple to get the baby to latch on to the breast and feed.

Sarah Vega, who is also an advisor to the Breastfeeding Committee of the Latin American Pediatrics Association and founder of the Association of International Consultants on Breastfeeding (IBCLC) of Peru /ACLAM Peru, emphasizes that it is not recommended to use this resource from the beginning, as is sometimes done in a simplistic manner, for three reasons:

1. The artificial nipple can become contaminated.
2. b) If it is no longer desired because the nipple has already formed with the baby’s sucking, it becomes difficult because the newborn has already become accustomed to it.
3. The best sucking is direct sucking. The contact of the baby’s mouth with the mother’s breast, areola and nipple contributes to the optimal development of the newborn due to the nerve endings in the oral cavity and the corresponding sensory stimuli.

Remember:

Breast milk is the best food there is for babies, since it favors their physical, mental, and emotional development. It also reduces the risk of mortality.

Dr. Sarah Vega
Pediatric neonatologist, and coordinator of
the Breastfeeding Unit at Clínica Ricardo Palma