Chapter 12. Nipple Issues
Nipple length is usually not the issue. It is common for babies to refuse direct breastfeeding after prolonged bottle use. You are doing a great job continuing to offer the breast despite your baby's refusal. Here is what to do next:
- Continue to hold your baby and attempt breastfeeding.
- Ask your lactation consultant to check your breastfeeding position.
- Change your feeding sequence: offer the breast first, then supplement with a bottle if needed.
The most important factor for successful breastfeeding is the elasticity of the nipple and areola—not the nipple's direction. Mothers with flat or inverted nipples can absolutely breastfeed! Babies with proper sucking technique may need time to adjust to inverted nipples. If you are considering a nipple shield, guidance from a lactation consultant on proper usage is essential, as incorrect use can lead to injury. In addition, you need a good let-down reflex if a nipple shield is used. Before breastfeeding, you can massage your breasts or hand express for a while until milk begins to drip. Then, allow your baby to suckle. If the let-down reflex is poor, milk flow may still be inefficient even with a nipple shield.
If you are using a nipple shield, a strong let-down reflex is essential. Before breastfeeding, try massaging your breasts or hand-expressing milk for a while. Once you see milk dripping, let your baby latch on. If your let-down reflex is weak, milk flow will likely be poor, even with a shield.