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Expert Q&A:
Are inverted nipples normal when you're pregnant?

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Elaine Zwelling
Answered by Elaine Zwelling R.N., Ph.D., L.C.C.E., F.A.C.C.E.
Elaine Zwelling, R.N., Ph.D., has been involved in maternal-newborn health care for 40 years. She has a bachelor's degree in nursing from Capital University and a master's degree in nursing and a Ph.D. in Family Relations and Human Development from Ohio State University. Dr. Zwelling brings to the Pampers Parenting Network her experience of helping expectant parents enjoy their pregnancy, plan and create a positive birth experience, and learn about parenting their newborn baby. She is certified by Lamaze International as a childbirth educator, is a Fellow in the American College of Childbirth Educators, and has taught childbirth classes for 25 years. Dr. Zwelling was the director and faculty for the Lamaze International Childbirth Educator Certification Program of Florida; in that role she prepared many nurses to become childbirth educators.

Dr. Zwelling was a Professor of Maternal-Newborn Nursing for 23 years at both Capital University and Ohio State University in Columbus, Ohio. At these institutions she taught undergraduate and graduate students and conducted research. For eight years she was a Senior Consultant with Phillips &; Fenwick, a women's health consulting firm in Santa Cruz, California, specializing in helping hospitals implement family-centered maternity care. Currently Dr. Zwelling is a Perinatal Nurse Consultant with the Hill-Rom Company. In this position, she provides comprehensive support and consultation to hospital maternity units to create quality care environments equipped with the appropriate equipment for labor and birth and provides clinical education for nursing staff.

Dr. Zwelling is the co-author of a maternal-newborn nursing textbook, Maternal-Newborn Nursing: Theory and Practice, and has published many professional journal articles related to maternal-newborn health care, family-centered maternity care, and childbirth education. Dr. Zwelling is a recognized speaker at professional conferences and teaches continuing education seminars for childbirth educators and perinatal nurses throughout the country.

Dr. Zwelling resides in Sarasota, Florida, and has a grown son, lovely daughter-in-law, and two grandchildren.

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Question


Are inverted nipples normal when you're pregnant?

Answer


The fact that your nipples are inverting is certainly no cause for worry, nor does it mean that you will not be able to successfully breastfeed. The first thing to do is conduct a little "test" to see if your nipples are truly inverted. Place your thumb above your nipple area (areola) and your index finger below, and press them together at the base of the nipple. Your nipple should protrude; if it flattens or inverts instead, then there are some things that are recommended for you to do prior to birth to help prepare your nipples so your baby can "latch on."

•  Nipple stretching. Grasp your areola just behind the nipple with your thumb and fingers, draw the nipple out, and then release. You can also roll your nipple between your thumb and fingers while the tissue is stretched; or place your thumbs at three and nine o'clock positions at the edge of your areola and gradually stretch the skin and nipple by pressing and moving your thumbs away from each other.
•  Breast shells. These are two-piece plastic dome-shaped cups that can be placed over the areola to draw out the nipple. They exert continuous, gentle pressure on the areola and cause the nipple to protrude through an opening in the inner plastic ring. The cups are worn under your bra for an hour or two each day in the last few weeks of pregnancy.

A word of caution in regard to any nipple-stretching techniques: Be alert to whether stimulation of the nipples is causing uterine contractions. If you have any concerns, discontinue nipple stimulation immediately to prevent preterm labor. Be sure to discuss these techniques with your care provider as well so that he or she can be aware and give any further suggestions.
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