What Are the Different Nipple Variations? (Types of Nipples)

There are many different shapes, sizes, and colors. One breast may also have a larger and differently shaped nipple to the other.

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Nipple Types

Think you have unusual nipples or strange nipples? We all have different nipples, nobody is the same, and not everybody has those so-called perfect breasts and nipples.

Most of the time, nipple variations will not cause a breastfeeding problem, but a few types of nipples and nipple differences may cause some difficulty.

Mothers with different nipple problems will need to take extra care that they have a good latch to prevent nipple pain.

Common Nipple Variations

Normal nipples are a little raised when not stimulated or erect. There are many different shapes, sizes, and colors. One breast may also have a larger and differently shaped nipple. Sometimes the different variations may cause some breastfeeding problems, but a mother can still breastfeed most of the time.

Flat Nipples

Flat nipples do not protrude when at rest, and when stimulated, they might only protrude a little. A mother with flat nipples, who breastfeeds, usually notices that her nipples protrude more over time due to the stretching of the nipple. Flat nipples can make it difficult for a baby to latch onto, but it is possible.

Some mothers who previously had normal nipples may notice that their nipples are flatter after birth. This may be caused by IV fluids, which are given with anesthesia drugs such as Oxytocin, Pitocin, or Syntocinon. The flatness of the nipples can also be caused by extra water retention owing to Pre-eclampsia.

A mother can massage her breasts and use nipple stimulation just before feeding to form an erect nipple for the baby to latch on.

Long or Extra Large Nipples

Some of the longest nipples are 2cm or more. Some of the most prominent nipples are 2.5cm in diameter and bigger. Usually, a large or long nipple will not cause a breastfeeding problem unless the oversized nipples are badly misshapen (deformed).

Extremely long nipples may cause the baby to gag while breastfeeding, but this improves as the baby matures.

Double Nipples and Bifurcated Nipples

Some ladies may have more than one nipple on the areola. A second or third nipple may or may not produce milk. The extra nipple may get in the way while breastfeeding but usually does not cause problems.

A Bifurcated nipple is a nipple with one or more separations; it is split into two or more parts. A bifurcated nipple does not generally hinder breastfeeding.

Folded Nipples

A folded nipple usually shows as a slit. The nipple is folded inwards. This can cause discomfort if the two sides of the folds rub against each other while breastfeeding.

Pierced Nipples

A nipple piercing should not affect a woman’s ability to breastfeed. The mother should take the nipple ring out while feeding; leaving it in could cause problems while breastfeeding and pose a choking hazard.

Nipples That Appear Inverted

These types of nipples are also called "pseudo-inverted nipples," "retractile nipples," or "umbilicated nipples,"

These nipples are only inverted at rest but become erect when stimulated or cold. This type of nipple only looks inverted and should not contribute to any breastfeeding problems.

Retracted Nipples

These nipples are normal at rest but become inverted when stimulated or when pressure is put on the areolae. Some mothers with retracted nipples might only notice a slight retraction, while others have nipples that retract entirely. This problem is usually lessened with each pregnancy and breastfeeding, with hormones and stretching of breast tissue.

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True Inverted Nipples

They are also called invaginated nipples. These types of nipples are drawn inwards while at rest and when stimulated. This happens because the internal adhesion inside the nipples keeps the nipple tied down.

True inverted nipples are rare, and some mothers only have one inverted nipple, while the other is normal. Some women think they have inverted nipples when they actually have inverted appearing nipples, which become erect when stimulated.

Absent Nipples

A rare congenital anomaly occurs when a woman does not have nipples or nipple pores. Breastfeeding, in this case, is impossible unless only one breast has this abnormality.

Treatment and Advice

  • Massage the breast to bring the nipple out (used for flat nipples). Nipple massage before nursing can also help make flat nipples more erect for breastfeeding.
  • Shape the nipple and breast with the hand. If the mother cups her breasts in a C hold and then gently presses towards her chest wall, the nipple should protrude more.
  • Pumped nipples: A breast pump can be used to pull the nipple erect just before a breastfeeding session.
  • A nipple enhancer (nipple extender) or syringe can be used to draw the nipple out just before a feeding. The Lansinoh latch assist is a little device that can help pull a nipple out before a breastfeeding session.
  • A nipple stretcher device called the Niplette (Avent) is made to stretch out the nipple. Nipple stretching is done during pregnancy to stretch the nipple out before the baby arrives.
  • Compressing the areola: This is usually done when the mother has fluid retention. Gentle pressure with the thumbs at the base of the nipples until an indentation occurs, then the same is done further up until at the rim of the areola. This can also cause a let-down, which could help a baby latch on more quickly.
  • Reverse pressure softening: the same method as above, except 3 to 4 fingers are used on each side of the breast. This also helps soften the breast and causes a let-down.
  • A nipple shield: A silicone nipple shield can be used for flat or inverted nipples if none of the other techniques work.
  • Continue to breastfeed: many mothers find that their nipples stay drawn out even after weaning. The sucking action stretches the tissues.
  • Nipple enlargement: Doctors can now loosen adhesions of the nipple to fix inverted nipples.
  • As a last resort, if your baby struggles to breastfeed on only one of your breasts, you can continue to breastfeed from just one breast. You can consider pumping exclusively if your baby struggles to breastfeed from both breasts.