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Flat Nipples, Poor Weight Gain

by Kathy Parkes Dupuis, Nakusp, British Columbia

I discovered I had flat nipples during my seventh month of pregnancy with my first child. Since they stuck out when they were cold, I figured I’d be OK. Oh, was I wrong.

Levi nursed immediately, latching on well, and in retrospect, if I had not nursed him right away I’m not sure we would have succeeded. On his second day he pretty much nursed non-stop, and I wouldn’t let the nurses take him away. It was on the third day that I got sore.

Hey, I was tough. I could handle a little pain. My nipples got red and shiny. At home, they got worse as the days wore on. Levi was constantly hungry, and latching him on was so painful I dreaded putting him to my breast. I persisted, mostly because I couldn’t stand the thought of not seeing my La Leche League friends, the only women with babies I knew, and all such kind mothers.

My nipples got worse. There would be only half a nipple sticking out from my breast and Levi would really have to suck to get the milk. I was in constant pain during each nursing (which lasted hours as Levi wasn’t getting enough). Sometimes my nipples would swell up like a sausage.

I tried ice to make my nipples protrude properly, but they wouldn’t respond. Finally, a chunk fell out of each nipple and white edges formed around the edges of these raw craters. In desperation I went to my doctor. He lifted my shirt, visibly backed up, and said “Gross!” I felt hopeless.

Meanwhile, another problem came up. Levi was not gaining well. The doctor must have alerted the health nurse because she hounded me every couple of days with her damned scaled. He was only gaining an ounce a week; it was obvious we weren’t measuring up. I began to express my milk and supplement Levi with it. By nine weeks he weighed only 8 lbs. 8 oz.. My doctor brought in another doctor and they both told me to supplement. I was nursing non-stop, day and night and Levi wasn’t gaining. I cried in pain and frustration.

At this time, I called my La Leche League Leader Jenny. She was supportive and she watched us nurse. My positioning wasn’t great; I’d start out with great intentions but soon I’d be slouched over

and he’d be on his back instead of tummy to tummy with me. I began to use an old heat lamp to help my nipples heal.

The pain continued and I had to stop nursing on my left breast for a while as every time I brought him to that nipple I would flinch so badly he couldn’t latch on. I expressed, to keep the supply up. Another thing began to happen as well. After nursing, the blood would completely drain from my nipples, and as they turned white, I had searing pain. I howled; my husband looked on helplessly. I figured I was losing it.

One day, when Levi was three months old and had just hit the ten pound mark, I latched him on and it didn’t hurt. I was overjoyed and relieved. It was so easy after that! Levi was always an avid nurser, and we continued our breastfeeding relationship for many happy years.

At a La Leche League Conference I learned from Kathleen Aurbach that pain inhibits the let down reflex. Levi was only getting foremilk those first few months, and he was gaining so slowly because he got no fatty hind milk. I also found out the blood draining from my nipples was real; it is called nipple blanching and is caused from a too-tight bra strap or poor posture which cuts off blood supply in the spine.

My flat nipples should have been pulled out; I could have stretched them prior to the birth, and rented an electric breastpump to draw them out.

Six years later I was pregnant again and determined to have a better beginning. I prepared as if going into battle. Nipple exercises, freezer full of food because I’d be nursing constantly and wouldn’t have time to cook, planned to use a breast pump, brought out my old heat lamp, and got a nursing pillow.

Hannah arrived after a very fast labour at home. The first night she was born I began using the heat lamp and continued for a couple of weeks just in case, but my nipples didn’t get sore. Hannah had no trouble latching on and gained weight like crazy. I’m not sure if it was because Levi nursed so long, or because I had prepared them, but my nipples didn’t even seem flat!

Whatever the reason, I am grateful.

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