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Inverted Nipples: Signs, Causes & Treatment

Inverted nipples are a common phenomenon many women experience. It is a natural expectation for the nipple to protrude outside, for breastfeeding. However, many women do not have these ideal nipples and can still breastfeed a baby successfully. Yes, despite inverted nipples breastfeeding is possible.

     

Book an Appointment with Dr. Hirday Kapoor for all Gynecology related concerns.

What Are Inverted Nipples?

Inverted nipples point inwards instead of outwards. In some cases, they can even lie flat. Inverted nipples can be noticed in one or both breasts. An inverted nipple also known as a retracted nipple is present from birth. However, if the nipples change or turn inwards later in life, it could indicate a medical issue that requires further investigation.

What Causes Inverted Nipples?

Some of the common causes of inverted nipple or retracted nipple are:

  1. Age

A woman’s breasts start changing somewhere around the mid-30s. The milk ducts start shortening as she ages and gets closer to menopause. Sometimes, this can result in the nipples moving into the body, otherwise known as retracting.

If you notice this, do not assume it is just age. Since the chances of breast cancer also increase with age, any change in your breasts should be checked. Your doctor can check and confirm if it is something to worry about or ignore.

  1. Injuries

Any injury to the breast or breast surgery can cause the milk ducts to retract, resulting in a retracted nipple in the affected breast.

  1. Breastfeeding

Though not very common, some women experience nipple inversion once they stop breastfeeding. If the milk ducts were scarred during breastfeeding, they can turn inward once you stop breastfeeding. This is just a possibility and does not happen with all breastfeeding women.

  1. Birth

Some are born with a retracted nipple or nipples. If the base for the nipples were small in the womb, the chances are that they did not have enough room to develop well. As a result, some children are born with inverted nipples.

  1. Mammary Duct Ectasia

Sometimes, when a woman is in her mid-40s(45-50 years), the milk ducts that carry milk to the nipples might become wider and result in clogging. This is called mammary duct ectasia. If you are experiencing the following symptoms along with nipple inversion, you need to consult your doctor immediately:

●      Tenderness in the nipples and breasts

●      Nipple and the surrounding area might turn red

●      Nipples may have a coloured discharge

●      Your doctor might give you some simple home remedies or warm compressions to unclog the nipples. If this does not help, they will give you antibiotics. If nothing works, they might suggest removing it surgically.

  1. Mastitis

Mastitis is a bacterial infection commonly found in new mothers who are breastfeeding or in women who suffer from cracked nipples or have nipple piercings. Some of the additional symptoms one may experience in case of nipple inversion due to such a bacterial infection are:

●      Breasts can feel hot or tender

●      Bloody discharge from the affected nipple

●      You may feel a lump behind the nipple

If you feel any of the symptoms, you need to consult your doctor immediately. Not attending to it immediately can worsen your infection. Your doctor might take an ultrasound or collect sample cells from the area of infection to confirm the diagnosis.

If the infection is severe or seems to be growing, your doctor will prescribe antibiotics. Some doctors may not be keen on prescribing antibiotics for an actively breastfeeding mother and might wait to see if the infection will clear on its own. If the infection seems to get worse with time, you may have to discontinue breastfeeding until the infection clears with medications.

  1. Areola Abscess

Sometimes an infection can form right under the areola – the dark part surrounding the nipples. The infection can lead to an abscess – area filled with pus. Smoking, nipple piercings or diabetes might cause this rare issue.

  1. Breast Cancer

As mentioned earlier, the chances of breast cancer increase with age. Retracted nipple or nipple inversion is a symptom of breast cancer and should be checked at the earliest. Early detection can help in effective treatment options.

Should You Worry About Retracted Nipples?

If you were born with a retracted nipple, there is nothing much to worry about. However, if you experience nipple inversion after a few years or if the inverted nipples cause any pain or discomfort, it is advisable to get them checked at the earliest. It may not be anything to worry about but one should never take that risk.

Can You Breastfeed With Inverted Nipples?

Yes, you can to a certain extent. If the retraction is not severe, you can try remedies or techniques to pull the nipple out. Inverted nipple breastfeeding can not only be difficult but can be painful too. Some women can still breastfeed if the nipple inversion is mild.

How to Fix Inverted Nipples?

Can inverted nipples be ‘fixed’? If so, how can you fix inverted nipples without surgery? Some of the inverted nipple remedies you can try without surgery are:

Hoffman Technique – This is a basic technique your doctor or lactation consultant might suggest when you start your breastfeeding journey. Follow these steps to help your nipples stand out:

1. Place both thumbs on the areola on either side of the nipples

2. Gently press your thumbs downward and pull them apart slowly

3. Repeat this step multiple times until you move all around the nipple

4. Repeat on the other side if you have a retracted nipple on that side too

5. Your nipples should stand out if there is just light inversion.

Nipple Eversion Device – In this method, your doctor might use a syringe or a suction cup device to help pull out the nipple. You can even wear hard plastic breast shells inside your bra. These shells will put pressure around the nipples and help them come out.

If neither of these techniques works, your doctor might suggest surgery. However, surgeries are recommended only for severely inverted or retracted nipple. It carries a risk of affecting the milk ducts. So, if you plan to breastfeed in the future, you need to discuss the pros and cons with your doctor and only then decide on the surgery.

Conclusion

Does an inverted nipple always mean cancer? No. it does not! Inverted nipples are nothing new. Many women have retracted nipples. Just like other parts of the body, the nipples can be different from idealistic expectations. If your nipples start retracting later in life, you need to check with a doctor to rule out other medical issues.

Must Read : All About the Miracle of Breastfeeding!

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