Nipples, anatomical variation
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Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier
Long nipples can lead to poor feeding because the baby is able to latch on to the nipple without drawing breast tissue into his or her mouth. The mother may need to be shown how to help the baby draw in a sufficient portion of the breast.
Short nipples should not cause any problems as the baby has to form a teat from both the breast and nipple. The mother should be reassured.
Abnormally large nipples If the baby is small, her/her mouth may not be able to get beyond the nipple and onto the breast. Lactation could be initiated by expressing. As the baby grows and the breast and nipple become more protactile, breastfeeding may become possible.
Inverted and flat nipples If the nipple is deeply inverted it mat be necessary to initiate lactation by expressing. Attempts to attach the baby to the breast are delayed until lactation is established and the breasts have become soft and breast tissue is more protactile.