Thursday, November 10, 2011

Solutions for Flat and Inverted Nipples

This week I met with my lactation consultant & received a set of the Supple Cups to try. This is something to be really excited about since I have flat nipples. I've had considerable difficulty breastfeeding both of my children. It was a lack of confidence & belief that I could do it with my firstborn son (an unplanned C-section will do that to you). It was lack of adequate support & education with my second-born daughter.
I've tried it all... I used the Medela contact nipple shields, Medela SoftShells for inverted nipples, the SNS (supplemental nursing system - where you pump breastmilk, then slowly feed it to your baby via a thin tube while he is at the breast), & even exclusive pumping for almost 4 months. The last one was hard since I had to pump at least every 3 hours during the day & go no longer than 5 hours at night in addition to bottle-feeding my baby. It felt like a full-time job.
Not being able to breastfeed contributed significantly to my post-partum blues making me feel like a total failure as a mother. I dreamed about being able to breastfeed naturally while snuggling & having skin-to-skin with my baby; not having to wake up during the night in order to attach myself to a cold machine & pump with the lights on; not having to drag the pump with me everywhere I went & arrange my life around the pumping schedule in order to maintain my milk supply; not having to pack premade formula with me while running errands with baby, & being able to just roll over in bed & breastfeed my baby at night without fully waking up.


That's why I jumped on a chance to try the relatively new on the market Supple Cups. The Cups are made of soft silicone & help by stretching the nipples using gentle vacuum. The use instructions state applying a small amount of lanolin onto both nipples & inside the Cups, centering the Cups onto the nipples & then squeezing the bottoms of the Cups while gently pressing them onto the nipples.
The Cups can be worn for 4-8 hours per day (but only 1-2 hours on the 1st day) starting in the 37th week of pregnancy (if a woman is not at risk for preterm labor). They can also be used post-partum. It's helpful to wear them for 2-5 minutes to draw out nipples before attempting to latch baby (especially during engorgement when nipples are flattened).


As someone who has tried the Philips Avent Niplettes (see photo above), I have a clear preference for the Supple Cups. First of all, the Cups are soft & flexible compared to rigid Niplettes which painfully dig into the breast tissue. Second, the Cups come in 3 different sizes & are able to accomodate nipples of various sizes compared to the Niplette's one-size-fits-all approach. Also the Cups stay on more easily since they don't have any plastic extensions (which can painfully stretch the nipples when accidently bumped). I can't really sit still for 4 hours so the Cups allow me greater mobility (I wouldn't go running, but I am able to do housework, for example).


I have also tried the Medela SoftShells for Inverted Nipples (see photo above) & had to stop after about 3 days due to itchy rash around my areolas. The Shells are supposed to be worn for several hours at a time, but don't allow much air circulation. They are also bulky & fall off relatively easily (it's not fun finding out that halfway through your shell-wearing session that the shell has moved & has been applying pressure to the wrong part of the breast).
The Cups give me hope for successful breastfeeding this time, & I feel truly inspired!

Additional Resources:

1) Breastfeeding With Flat or Inverted Nipples by Becky Flora, BSed, IBCLC

2) Flat or Inverted Nipples by Anne Smith, IBCLC

3) Flat or Inverted Nipples by Barbara Wilson-Clay, BSEd, IBCLC

4) Do I Have Flat or Inverted Nipples?

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