Inverted or flat nipples

Flat or inverted nipples may make it difficult for your baby to attach to your breast. However, it is still possible to breastfeed using nipple shields.

Nipple shields are thin silicone covers that can be placed over the nipple to assist with breastfeeding.

Nipple shields should not be used:

  • until milk is in and flowing well
  • when nipples are damaged from poor attachment to the breast
  • when breasts are engorged and baby cannot grasp the swollen breast tissue.

Tips for using nipple shields

  • The large size is preferable for most women (regardless of nipple size) to ensure effective milk transfer.
  • If you have trouble using your nipple shield, try asking for help from a lactation consultant or breastfeeding counsellor.
  • If your baby is not well attached, you will notice a decline in your supply.
  • Milk can take longer to flow from the breast when a nipple shield is used so feeds may take longer to finish.
  • To ensure breasts are well drained it may be necessary to express for a few minutes after feeds.
  • While you are feeding with a nipple shield, it is recommended that you have your baby weighed weekly or at least fortnightly to ensure adequate growth.

How to use nipple shields

  • Express a few drops of milk to start the milk flowing.
  • Smear breast milk onto the outside of the shield to encourage your baby to attach.
  • Place nipple shield over nipple and hold it in place with fingers at the outer edge.
  • Touch baby's lips with nipple shield, wait for a wide-open mouth then bring your baby quickly onto the shield. It is important that the baby does not slip back off the shield as this will cause pinching and nipple damage.
  • Make sure the baby is sucking AND swallowing.

Cleaning the nipple shield

  • Generally there is no need to sterilise the nipple shield after each use.
  • Rinse in cold water after use, then wash in hot soapy water and rinse under hot running water.
  • Drain, dry and store in a clean covered container.

Weaning from the nipple shield

It is recommended that baby eventually feed directly from the breast and attempts to do this should be made after a week or two. The transition from nipple shield to breast can sometimes be difficult. Removing the shield part way through a feed when the nipple is drawn out may make direct attachment easier. If you have access to a lactation consultant or breastfeeding counsellor it may be a good idea to get some support. 


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