Small or large, pointing straight out or hanging east and west, inverted or pretty proud to see you… nipples come in all shapes and sizes. And the anatomy of yours can affect how well your baby latches on, as well as which breastfeeding position will work best for you both.
Given that both you and your baby are unique, it makes sense that there is no ‘one size fits all’ when it comes to breastfeeding.
‘Think of breastfeeding as a two-piece puzzle with your nipple and your baby’s mouth as two puzzle pieces,’ says Geraldine Miskin, a breastfeeding specialist. ‘Sometimes the fit is perfect. Sometimes the fit is less-than-great to start with, but gets better with time. And sometimes the size or shape of your nipples might makes getting your milk trickier for your baby. And this might be leading to long feeds, frequent feeds, nipple soreness or slow weight gain, even when you have the “perfect” position and a “textbook” latch.’
Sound familiar? Then let’s nip those problems in the bud! ‘Whatever the anatomical fit of those puzzle pieces, there is always a way to ensure that your baby gets your milk,’ promises Geraldine. So don’t worry for even a second if your nipples are small or extra-large: ‘Nipples come in different shapes and sizes’, says Geraldine. ‘And there is no right or wrong! It’s all about how you and baby work or fit together.’
How to find your best breastfeeding position
‘Just like us, babies are all different,’ says Geraldine. ‘They are born at different ages and sizes and this influences how big baby’s mouth is, and that affects the breastfeeding jigsaw.’ For instance, a small baby latching onto a long, wide nipple will need a different position to a larger baby latching on to a flat and narrow nipple. It’s all about you finding the best breastfeeding position for you and your baby.
Nipple size breastfeeding
If your nipple looks too big for your baby’s mouth...
‘If your nipples are average in length, your baby will be able to scoop up more breast or areola when latching,’ says Geraldine. ‘The trick is to position him nose-to-nipple at the start. This way he’ll have an off-centre latch with his lower lip on your areola and his top lip just next to your nipple. This will get your nipple to the back of his mouth where it’s comfortable for you both.’
If your nipples are long…
‘If you have long nipples, focus on the position of your baby’s lower lip when you latch on. The closer your baby’s lower lip is to your nipple, the easier it will be for him to latch on. This is different to the standard advice but, as your nipples are longer and your baby’s mouth can only open so wide, you need to adapt your positioning a little,’ suggests Geraldine.
‘So, think about placing his lower lip about half a finger’s space away from the nipple base. And as your baby gets bigger, position his lower lip slightly further away from the nipple base.’
If your nipples look too small for your baby’s mouth…
‘As your nipple is small, your baby relies on scooping up a lot of breast tissue,’ explains Geraldine. ‘So, line him up nose-to-nipple and bring him directly onto your breast, so that his chin indents your breast and your nipple moves into his mouth.
If he doesn’t scoop up enough breast tissue, he’ll find it tricky to keep the breast securely in place, especially when your milk begins to flow. If this happens, line him up more mouth-to-nipple and then pinch your breast together, as described above, to help him get a good mouthful of breast to hold onto.’
If your nipples are long and wide…
‘Aim to latch your baby onto your breast with a little more areola close to his lower lip. So, line him up more upper-lip-to-nipple or, if you need to, mouth-to-nipple,’ says Geraldine. ‘However, if his mouth is too small to do this, and he can physically only latch onto your nipple and it doesn’t hurt, just go with it.
As your baby gets bigger, he will be able to scoop up more breast tissue in time. Do check your baby’s weight gain to make sure that he’s getting enough milk, as often mums with long and wide nipples have babies who look like they are latching and feeding, but don’t gain weight because they aren’t able to access the glandular tissue and get milk.’
If you have inverted nipples…
About a fifth of women have inverted nipples, when the nipple points in, rather than out. Not sure if yours are?
An easy way to check is to gently squeeze the base of your nipple: if it retracts into your breast, it’s inverted, while a non-inverted nipple will point out.
Having inverted nipples won’t stop you from breastfeeding, but it does throw up some issues. ‘Inverted nipples have less elasticity than pointy-out nipples because part or most of the nipple is pulled and tethered into the breast,’ explains Geraldine. ‘This means that when any suction is applied to the nipple, you’ll feel pain.’ There are simple but effective breastfeeding positions you can try to overcome this. ‘If you can encourage your baby to scoop up plenty of breast tissue when he latches on, then inverted nipples aren’t a problem,’ says Geraldine. ‘If your breasts are small, full and firm, which makes this difficult, then use a nipple shield.
This looks like a little sombrero, which you place over the nipple, and then latch your baby onto the shield. Choose a firm shield, because your baby something firm to latch onto. If the shield you use is too flimsy, it’ll collapse as soon as your baby starts to suck.’
If you have flat nipples…
Shields are also the answer if you have flat nipples, when your nipple stays flat and doesn’t point out or in. ‘To work out what size shield you need,’ says Geraldine, ‘look at your nipple circumference in line with your fingers. If your nipple circumference is roughly the same circumference as your little finger, try the small size.
If it’s closer to your middle finger, you’ll want medium and, if it’s nearing thumb-size, get large. Be aware, too, that the size you need might be too big for your baby, so buy the size you think will work for you and the smaller size. too. And re-assess once your baby is a little older and his mouth has grown bigger. It has to work for both of you, so you may need to experiment a little to find a shield you’re both happy with.’
What size are your nipples?
You can breastfeed however big or small your nipples are! There aren’t any official guidelines when it comes to nipple size, but this gauge is a handy guide for those of you who’ve never considered your nipple size before and are curious!
How wide?
Measure the width of your nipples at their base (not your areola).
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Less than 12mm: small
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12-15mm: average
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16-23mm: large
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More than 23mm: extra-large.
How long?
Less than 5mm: flat
5mm-12mm: average
More than 12mm: long
Meet the expert: Geraldine Miskin is an independent breastfeeding specialist and founder of maternity nurse agency Miskin Maternity.
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