Breastfeeding advice with flat nipples

[Blue2020]

Hi, I should start by saying I’m 28 weeks pregnant.

It will be my second DC, but never managed to breastfeed the first due to many reasons (came early, exclusively pumped, then ruined supply with bad advice, he never latched).

Im hoping I go to full term this time to have a better chance of that initial period without dc being tube fed, taken away etc, however due to last time I’m under no illusions that it will be easy or even work. I can’t ask friends because their babies all latched on straight away and they all say how easy it was, which is honestly great for them but not helpful advice for me.

My main point is that for most of the time I have flat nipples. I say most because on rare occasions they stick out the slightest bit. I know it’s breast feeding and not nipple feeding, but I’m sure it’s also the nipple that helps and touches the roof of their mouth?

Does anyone have flat nipples and advice about the best chances to succeed? I would just like to be prepared to give it every chance this time.

I had flat nipples and I didn’t realise, no one told me it could be an issue, and I tried for weeks to breastfeed to no avail. Then, the 5th midwife came round and said I had flat nipples, she said I needed to tweak my nipples before breastfeeding or use nipple shields. I used nipple shields for about a month, and then breastfed my 1st for 2 years. My second, I breastfed for 6 months, with no issues as my nipples were no longer flat after 2 years of breastfeeding my first.

It is great you are aware of the possible issue now, pack nipple shields and don’t be too hard on yourself if baby can’t latch initially. Don’t put too much pressure on yourself.

Definitely try to express colostrum before you go in, as I didn’t the first time and balancing a crying baby, whilst trying to squeeze colostrum with a sore tear was very stressful. I also dropped numerous syringes on the floor with the stress. So, express colostrum in the space of your own home, from the point it is ok to (I think it’s from 36 weeks). Put them in the freezer and bring the bag with you. This takes the pressure off if baby doesn’t latch initially. Bring a pump with you to the hospital too, just pump if baby doesn’t latch, as I lost supply because I wasn’t doing enough and my first was crying from hunger. Any questions always happy to help!

@Tadah2 thankyou, which nipple shields did you use? I will look into them.

My first came at 35 weeks due to preeclampsia so I never managed to try colostrum harvesting. I did try the day after the csection but nothing came out so I started pumping and that worked well. I’m hoping I make it full term this time so I will try that. I have a pump already.

I felt like a deer in headlights with my first, very little knowledge and then everyone having their own views. I feel like I can advocate for us a bit better this time and go into it more open minded, but also know when I’m reaching a breaking point and be willing to call time without feeling like I failed (I hope). I am not against formula either though, my first moved onto formula once my supply dropped and I couldn’t keep up with him, and he’s now a healthy toddler. The flat nipples part is the unknown for me though.

It’s great to hear that you managed to breastfeed.

I was exactly the same first time, felt I was drowning. Ended up with bad PND and wish I had just given my first the bottle.

It would be worth giving a bottle occasionally too, I know this goes against all the rules, but my first refused the bottle and I had to feed him every 30 mins (day and night) for a year. We spent thousands trying to make him take the bottle, so having baby happy and content with the bottle is always good too - whether formula or pumped milk!

Ah I used a few, but I found the Medela and Mam nipple shields the best. Sometimes you feel you are wasting a lot of milk, as they can leak. Other than investing in a good pump (which is number one) the other thing I bought was the Haakaa. Great if your other breast leaks whilst feeding, and is good for making the nipple more pronounced.

@Tadah2 I have seen that with a few friends who ebf. Their baby wouldn’t take a bottle at 6-9m or even a cup they rejected. One of them said they would combi feed next time. I likely would introduce a bottle around 3-4 weeks that DH could give once a day or every other day- I say this but I need to figure out bf can even work first.

I will look into those ones thanks. I bought these medela cup things that are supposed to catch the other side. No idea if they are any good though.

Also with my last pregnancy I was leaking at night from 24ish weeks onwards. This time I haven’t had any leaking whatsoever and I’m 28 weeks. I’m hoping that’s not a sign of issues. I know some people don’t leak at all before and it’s all fine. I’m just comparing the two pregnancies so far.

Similar story here OP. First was tube fed as unwell, when we tried latching it didn't work, I exclusively pumped for 9 months. I'm completely flat except when stimulated and even then the nipple sticks out only a tiny bit.
I am currently breastfeeding my 12mo second born and honestly it couldn't have been a more different experience. She just knew what to do and so did I. I did try latching without shields a few times but it was very painful and I could see she had almost no areola in her mouth which wasn't right.
As others said, definitely express colostrum. We gave 2-3ml at a time, just to be sure baby was getting milk, and each time I did hand or manual pump expression to encourage supply. After first 3 days I was confident she was swallowing milk and stopped that.
Before birth I got out the different brands of shields and worked out my size, I encouraged some nipple stimulation and looked at where the ducts oozing colostrum were then picked the size of shield that would cover them all. For me that is Medela large.
At night, I use double sided tape available from a breast prostheses website to stick the shield on all night. I cut each little strip up into 4 small bits. This has enabled me to side lie feed and is amazing. I got myself quite worked up trying to hold shield on in middle of night in the dark and repositioning umpteen times when baby moved was a nightmare.
Don't let yourself get upset when you hear the inevitable comments about shields. I went to a La Leche group a few times and the leader just couldn't help herself asking questions about whether I'd try to get off shields or when I would try again without, like this was the ultimate goal. For me the goal was just nursing baby, however that was, and I know baby can't latch without them because there's just nothing to pull into her mouth. I really don't get the negativity towards them. They are utterly essential to my BF, and so what. AND big pro, on a few long car journeys when baby was screaming, I have sat next to her with the shield over my finger in her mouth and she's settled, can't do that with an attached nipple 😂.

Nipple shields, after 6 months of ebf I didn't need them, saves on cracked nipps too 😀

Hi,

I have flat nipples that only stick out after stimulation and I have successfully breastfed my first baby for 5 months now. It can be done but it was super hard work!

I was determined to breastfeed and was devastated when it didn't work at first. DD was born nearly 3 weeks early and weighed 6lbs 4oz. I had to get stitches in a different hospital so never got skin to skin at the beginning. DD was very sleepy and she would not latch at all. I hand expressed my colostrum and syringed it into her mouth. (Pumping colostrum is a waste of time as it's only a few MLS and will just get lost in the pump mechanism). As my milk started to come in I expressed into a cup and cup fed, then as I had more milk hand expressed into a bottle. I always tried breast first (which failed and she would cry) and then would hand express and feed via bottle. I stayed in hospital for 2 days getting help and then went home.

I continued this at home with a lot of support from my partner and mum. It was such hard work. I discovered the flipple technique to hold my breast to help baby latch and this started to work and after about 7-10 days managed our first breastfeed. After that I ditched the bottle and practiced and practiced, every feed was fingers and thumbs and difficult but she was gaining weight with my milk.

I then got sore cracked nipples and was in a lot of pain. I saw an NHS lactation consultant and she got me to do the koala feeding position in a leant back position and this fix the nipple pain. Since then everything has been fine. Thankfully DD always gained weight well and I think my supply has always been good because I hand expressed from the start to get my milk supply going.

I found my local breastfeeding support group extremely helpful. A lot of other mums had similar difficulties getting their babies to latch. It took me about 2 months before it started to feel more natural and 3+ months before I stopped overthinking or worrying about it. I cried a lot over breastfeeding for the first 7 weeks, so much my family were starting to get worried but I'm so glad I persevered and it's now such a lovely way to feed and nurture her. Her latch is still not perfect but I'm not sore and she's thriving so that's all that matters. I hope this helps and good luck!! You can do it!