Some nipples are flat or inverted, which means they are turned inwards, but if your nipples usually come out slightly when you are sexually aroused or feel cold, then you shouldn't really have a problem.
Between 7 and 10% of pregnant women who want to breastfeed have truly inverted nipples (their nipples won't come out at all) or poorly protractile nipples (nipples which don't come out much). Fortunately, nipple shape and protractility often improve in pregnancy and many women with nipples like this manage perfectly well, especially if they have someone who can help them position their babies and remind them not to limit the number or length of breastfeeds, or give bottles of formula.
If you still have inverted nipples at the end of pregnancy your baby may still be able to suck efficiently if you 'make a biscuit' of your areola and nipple with your thumb and forefinger and offer it to him. Engorgement is the number one enemy of successful latching-on in women with inverted nipples, so avoid this at all costs and encourage your milk to let down before baby feeds.
One of the best things you can do is to speak with your midwife or lactation consultant.
Dr. Penny Stanway
June 2009
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Sore Nipples
