Educational Resources

Testing for inverted or flat nipples

A pregnant woman may discover that she has flat or inverted nipples. Inverted nipples are caused by adhesions which hold the nipple back toward the chest wall. When baby tries to grasp the nipple during a feeding, the nipple may pull away instead of protruding into his mouth. A baby can learn to effectively milk the breast without protruding nipples; however many babies become frustrated by this situation.

It is ideal to check for inverted nipples during the second trimester of pregnancy because they may be able to be corrected before the baby arrives. A simple “pinch” test will indicate if the mother has inverted or flat nipples. Grasp the nipple about one inch behind the base (where the nipple joins the areola) with the forefinger and the thumb. Press fingers together several times around the nipple base.

• If the nipple protrudes easily while pinching, the nipple should not require any preparation for breastfeeding.

• If the nipple appears to be inverted but protrudes during the test, no prenatal preparation is necessary.

• If the nipple appears to protrude but goes back in when pinched, it is inverted and will benefit from prenatal treatment.

• If the nipple appears inverted and remains inverted during compression, prenatal treatment is indicated.

• Occasionally the nipple will appear to be flat or only slightly inverted and responds to stimulation as an inverted nipple. Prenatal treatment is recommended.


This educational material is provided courtesy of Ameda Egnell.  Permission to use and/or reproduce this copyrighted material has been granted by the distributor, Hollister Incorporated.