An inverted nipple breastfeeding shield is a thin silicone cover worn during feeds that creates a firmer, protruding surface so your baby can latch when your nipple retracts inward. Whether you need one depends on your grade: Grade 1 (flat) usually responds to pre-feed pump suction or reverse pressure softening alone, Grade 2 (partial) often benefits from a shield, and Grade 3 (fully inverted) typically requires one for most feeds. A lactation consultant should fit the shield by nipple base diameter.
The three grades of nipple inversion and what each means for breastfeeding, five eversion techniques (including reverse pressure softening) to try before feeds, when and how to use a nipple shield for latch support, which breastfeeding positions give you the most control with flat or inverted nipples, and how to build a practical toolkit that evolves as your baby's latch improves over the first six weeks.
Inverted or flat nipples affect an estimated 10–20% of women. The nipple retracts inward rather than protruding outward — and for many mothers, this only becomes a concern when breastfeeding begins. The good news: most women with inverted nipples can breastfeed successfully. It often takes the right technique, the right tools, and professional guidance from a lactation consultant.
The key is understanding your specific grade of inversion, because the approach is different for each. A Grade 1 "flat" nipple may only need gentle stimulation before feeds, while a Grade 3 fully inverted nipple may require a nipple shield and specialized devices. Inverted nipples are almost always congenital — meaning you were born with them — and are caused by short milk ducts or tight connective tissue beneath the nipple. In rare cases, inversion develops later due to breast surgery, infection, or duct ectasia. A new-onset inversion after puberty should always be evaluated by your healthcare provider to rule out other causes. The American Academy of Pediatrics recommends working with a certified lactation consultant (IBCLC) who can assess your anatomy and create an individualized plan.
The Three Grades of Nipple Inversion
Nipple inversion is a condition where the nipple retracts inward instead of protruding outward, classified into three grades based on how easily it can be drawn out and whether it stays protruded. The medical grading system — developed by Schwager and colleagues and widely used in clinical practice — determines your entire approach to flat nipple breastfeeding.
One important note: breast engorgement in the first days postpartum can make nipples appear flatter or more inverted than they actually are. If your nipples seemed normal during pregnancy but look flat after delivery, this may be temporary swelling — not true inversion. Reverse pressure softening (covered below) can help distinguish the two.
Grade 1 — Flat
Nipple sits level with the areola or is mildly inverted. Can be easily drawn out with gentle pressure and stays protruded for a sustained period. Minimal or no fibrosis. Milk ducts intact. Breastfeeding usually possible with positioning adjustments or brief pre-feed stimulation. Sometimes called "shy nipples."
Grade 2 — Partial
Nipple can be drawn out but retracts back when released. Moderate fibrosis with retracted milk ducts. Breastfeeding is possible but baby may have difficulty latching. Typically benefits from eversion techniques before feeds and/or a nipple shield during feeds. Breast shells worn between feeds may also help maintain eversion.
Grade 3 — Fully Inverted
Nipple cannot be drawn out manually. Significant fibrosis with constricted, severely retracted milk ducts. Breastfeeding is very challenging without assistance. Usually requires a nipple everter device, nipple shield, and close LC guidance. If direct latching isn't achievable, expressing milk or feeding from the less-affected breast may be alternatives.
Five Eversion Techniques
Eversion is the process of drawing the nipple outward before latching, presenting a more protruding surface that your baby can grasp. These techniques are most effective for Grade 1 and Grade 2 inverted nipples breastfeeding; Grade 3 may need a dedicated everter device. Start each feed with skin-to-skin contact — place your baby directly on your bare chest, as this triggers natural feeding reflexes and encourages instinctive latching even with flat nipples.
1. Pump suction (30–60 seconds). Apply your breast pump flange and run it briefly — just long enough to draw the nipple into the tunnel. This is the most commonly recommended technique by lactation consultants. Use the lowest effective suction setting. The NHS recommends this as a first-line approach for flat or mildly inverted nipples.
2. Reverse pressure softening. Place two or three fingertips around the base of your nipple and press firmly inward toward your chest wall for 30–60 seconds. This technique moves swelling backward into the breast tissue, softening the areola and helping the nipple evert naturally. It's especially valuable in the first days postpartum when engorgement makes nipples appear flatter than they are. La Leche League International recommends this as a foundational step before other eversion methods.
3. Hand expression. Gently express a few drops of milk before latching. This serves two purposes: it softens the areola (making latch easier) and places milk on the nipple surface so your baby is immediately rewarded when they begin to suck. Johns Hopkins Medicine recommends hand expression as a practical first step for flat nipple breastfeeding.
4. Nipple everter / suction device. Small suction cups (like the Niplette) apply gentle sustained negative pressure. Place over the nipple for 30–60 seconds before feeds. Most effective for Grade 1 and some Grade 2 inversions. Available without a prescription. Breast shells — smooth plastic or silicone cups worn inside the bra — are a related option that applies gentle continuous pressure between feeds to encourage eversion.
5. Cold stimulation. Brief contact with a cold, damp cloth can trigger the nipple to protrude reflexively. This is the simplest technique and can be combined with any of the above. Works best for Grade 1. Avoid making the nipple too cold, as numbness can inhibit your let-down reflex.
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Shop Silver Cups — 20% OFFGo Mommy LLC manufactures and sells the Silver Nursing Cups and Portable Bottle Warmer referenced in this article. Go Mommy does not manufacture nipple shields, everter devices, breast shells, or breast pumps. Information about those tools is based on published clinical guidelines from the sources listed above. Product recommendations for non-Go Mommy tools are brand-neutral.
When a Nipple Shield Can Help
A nipple shield is a thin silicone cover worn over the nipple during breastfeeding that creates a firmer, more protruding surface to compensate for what the inverted nipple cannot yet provide. For Grade 2 and Grade 3 inversions, an inverted nipple breastfeeding shield is often the bridge that makes direct breastfeeding possible while you work on the underlying latch.
Proper sizing matters — the shield should be fitted by your lactation consultant based on your nipple base diameter (typically 16mm, 20mm, or 24mm). An incorrectly sized shield causes more problems than it solves: too small compresses and restricts flow, too large slips and allows air swallowing. For a detailed step-by-step guide, see our nipple shield guide.
Shields are temporary. As your baby grows stronger and your nipple tissue responds to repeated feeding, many mothers wean off the shield within 4–6 weeks. A helpful weaning strategy: remove the shield partway through a feed, once your nipple is drawn out and your milk is flowing, to encourage direct latching. La Leche League International emphasizes that shields should always be used under professional guidance with regular follow-up to assess progress and monitor milk transfer.
Best Breastfeeding Positions
Breastfeeding positions for inverted nipples should prioritize latch control — your ability to guide your baby's head angle and depth onto the breast. The right position gives you the leverage to work with flat or inverted anatomy rather than against it.
| Position | Why It Helps | Best For |
|---|---|---|
| Football / Clutch Hold | Baby tucked under your arm. Your hand supports baby's head directly, giving maximum control over latch angle and depth. | All grades. Recommended starting position. |
| Cross-Cradle | Your opposite hand guides baby's head for precise positioning. Baby faces you tummy-to-tummy. | Grade 1–2. Good once basic latch is established. |
| Laid-Back / Biological | You recline and gravity helps baby find the nipple instinctively. Triggers baby's natural feeding reflexes through skin-to-skin contact. | Grade 1. Good for relaxed feeds once latch confidence builds. |
Latch sequence for inverted nipples: Tummy to tummy positioning first. Nose to nipple alignment. Wait for a wide-open mouth — don't rush this. Then guide baby chin-first, directing the nipple (or shield) toward the roof of baby's mouth. For flat nipples, try the breast shaping technique: use both hands to compress the breast into a flatter "sandwich" shape (C-hold or U-hold), which gives baby a larger surface to grasp. Some lactation consultants call this the "flipple" — tilting the nipple upward and tucking baby's chin in first for a deeper, asymmetric latch. The Mayo Clinic provides illustrated latch guidance for new mothers.
Your Feed-Cycle Toolkit
Each feed with inverted nipples follows a cycle of four phases — pre-feed eversion, during-feed support, after-feed recovery, and ongoing follow-up. Different tools serve different moments, and not every grade needs every tool.
| Phase | Tool | Purpose |
|---|---|---|
| Pre-feed (1–2 min before) | Reverse pressure softening, pump suction, hand expression, everter, or cold stimulation | Draw the nipple outward so baby can latch |
| During feed | Nipple shield (if needed for latch) + breast shaping | Provides a firmer surface baby can grasp |
| After feed | Silver nursing cups | Reduces friction from clothing, leverages the natural properties of silver |
| Between feeds | Breast shells (optional, Grade 2–3) | Gentle continuous pressure to maintain eversion |
| Ongoing | LC follow-up + weekly weight checks | Track progress, adjust shield size, plan weaning |
Between Feeds: Silver Cups
Silver nursing cups are dome-shaped cups made from solid silver, worn inside a nursing bra between feeds to protect sore or tender nipples from clothing friction and to support skin recovery with expressed breast milk. Inverted nipples that are repeatedly everted for feeds — especially with pump suction — can become sensitive and irritated between sessions. The cups create a smooth barrier that leverages the natural properties of silver for surface protection.
This is particularly relevant for mothers working through Grade 2 and 3 inversions, where more aggressive eversion techniques (pump suction, everter devices) can leave the nipple area tender. The cups complement the rest of your inverted nipples breastfeeding toolkit without interfering with any of it. Express 1–2 drops of breast milk into the dome before placing the cup — no creams, balms, or oils inside the dome. For complete usage guidance, see our silver cups guide. The Office on Women's Health provides additional guidance on managing nipple discomfort during breastfeeding.
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Shop Silver Cups — 20% OFFWeek-by-Week Progress
Most families see meaningful improvement within the first few weeks. The timeline varies by grade, but a typical progression looks like this:
| Week | What to Expect |
|---|---|
| Week 1 | Full toolkit at every feed — skin-to-skin, reverse pressure softening, eversion technique, shield if needed, silver cups between feeds. Focus on establishing a consistent routine and ensuring adequate milk transfer through weekly weight checks. |
| Week 2–3 | Begin reducing shield use during easier feeds where baby latches well. Try removing the shield mid-feed once your nipple is drawn out. Continue eversion before every feed. |
| Week 4–6 | Many babies latch without a shield, especially for Grade 1–2. Continue silver cups for between-feed comfort as needed. Your nipple tissue is becoming more elastic from repeated feeding. |
| Week 6+ | Most Grade 1–2 parents are shield-free. Grade 3 may take longer — some mothers continue shield-assisted feeding long-term, which is entirely valid. Continue LC follow-up to confirm milk transfer and weight gain. |
When to Seek Help
See your lactation consultant or healthcare provider if baby is consistently unable to latch despite eversion and shield use, if weight gain slows or diaper output drops (fewer than six wet diapers per day after day four), if you experience persistent nipple pain or damage that doesn't improve with technique adjustments, if you see signs of mastitis (red, hot areas on the breast, fever), or if you have a new onset nipple inversion after puberty (which should be evaluated to rule out other causes). If your baby can't latch on the more affected breast, breastfeeding exclusively from the less-affected side is a valid approach — most women produce enough milk from a single breast. The CDC and Stanford Newborn Nursery provide additional clinical resources for breastfeeding support.
📋 Editorial Note
Last reviewed: April 2026
Authored by: Go Mommy Editorial Team — the editorial arm of Go Mommy LLC, manufacturer of silver nursing cups. Our team combines manufacturing expertise with clinical literature review.
Production method: This article was produced using a hybrid workflow — AI-assisted research and drafting, followed by human editorial review against peer-reviewed clinical sources (AAP, CDC, Mayo Clinic, LLLI). Every clinical claim is verified before publication.
Go Mommy content is developed by our editorial team and verified against peer-reviewed guidance from the AAP, CDC, Mayo Clinic, and La Leche League International. This article is for educational purposes and does not replace medical advice from your healthcare provider.
Product Disclosure: Go Mommy LLC manufactures the Silver Nursing Cups and Portable Bottle Warmer referenced in this article. Go Mommy does not manufacture nipple shields, everter devices, breast shells, or breast pumps. Information about these tools is based on published clinical guidelines.
Sources: AAP · ABM · CDC · Johns Hopkins · LLLI · Mayo Clinic · NCBI StatPearls · NHS · Stanford · OWH
Related Guides:
- How to Use a Nipple Shield — Step-by-Step Guide
- How to Use Silver Nursing Cups — Step-by-Step Guide
- Best Nipple Shields — Complete Guide
- Flat Nipples and Breastfeeding Guide
- Breastfeeding Positions and Latch Guide
- Best Silver Nursing Cups — Buyer's Guide
- How to Clean Silver Nursing Cups
- Cracked Nipples Treatment — Gentle Remedies
🎯 Key takeaways
- Inverted nipples affect 10–20% of women and are classified into three grades based on how easily the nipple can be drawn out — each grade requires a different approach to breastfeeding.
- Pre-feed eversion techniques — especially reverse pressure softening and pump suction for 30–60 seconds — are the foundation for all grades; latch your baby immediately while the nipple is everted.
- A nipple shield fitted by a lactation consultant (typically 16mm, 20mm, or 24mm) bridges the gap for Grade 2 and Grade 3 inversions and is usually temporary, not permanent.
- The football hold gives maximum head-angle control for latch — combine it with breast shaping (C-hold or "flipple") to give your baby a larger surface to grasp.
- Silver nursing cups worn between feeds protect tender, repeatedly everted nipples from clothing friction and support skin recovery with expressed breast milk — no creams, balms, or oils inside the dome.
- Most Grade 1–2 mothers wean off the shield within four to six weeks as nipple tissue becomes more elastic from repeated feeding; Grade 3 may take longer and that is entirely valid.
- Seek professional help if your baby cannot latch despite eversion and shield use, if weight gain slows, or if you notice signs of infection — early LC support prevents small problems from becoming persistent ones.
Frequently Asked Questions
Can I breastfeed with inverted nipples?
Yes — most women with inverted nipples can breastfeed successfully. Grade 1 and 2 inversions respond well to eversion techniques and nipple shields. Grade 3 is more challenging but not necessarily impossible with professional support. Remember: the baby latches onto the areola and breast tissue, not just the nipple.
How do I know my grade of inversion?
Do the pinch test: compress behind the nipple base with your thumb and forefinger. If the nipple protrudes and stays — Grade 1. Protrudes but retracts quickly — Grade 2. Won't come out at all — Grade 3. A lactation consultant can confirm your grade and recommend the right approach for your anatomy.
What is the best eversion technique?
Reverse pressure softening and pump suction for 30–60 seconds before feeding are the most commonly recommended approaches. Combine with hand expression for Grade 2. Grade 3 may need a dedicated nipple everter device. Always latch baby immediately after eversion — the effect is temporary.
Do I need a nipple shield for inverted nipples?
Not always. Grade 1 often manages without one. Grade 2 frequently benefits from a shield, especially in the early weeks. Grade 3 typically needs a shield for most feeds. A shield should be fitted by an LC based on your nipple base diameter and treated as a temporary bridge, not a permanent solution.
Will my nipples stay inverted forever?
Not necessarily. Pregnancy hormones and the baby's repeated sucking can gradually draw inverted nipples outward. Many women find their nipples become less inverted over weeks of breastfeeding. Some stay permanently protruded after the breastfeeding period ends.
How do silver cups help with inverted nipples?
Silver cups are worn between feeds — not during. They create a smooth barrier that leverages the natural properties of silver and prevents clothing friction on nipples that have been repeatedly everted and are tender. They complement the shield (used during feeds) and eversion tools (used before feeds).
What causes inverted nipples?
Most inverted nipples are congenital — caused by short milk ducts or tight connective tissue beneath the nipple during fetal development. They can also develop after breast surgery, infection (mastitis, duct ectasia), or significant weight loss. A new-onset inversion after puberty should be evaluated by a healthcare provider to rule out other causes.
Should I treat inverted nipples during pregnancy?
Current evidence does not support treating inverted nipples during pregnancy. La Leche League notes that early "diagnosis" may even undermine confidence without clinical benefit. Focus instead on learning breastfeeding techniques, finding a local IBCLC, and preparing for skin-to-skin contact immediately after birth.
Can I breastfeed without a shield if I have flat nipples?
Yes — many mothers with flat nipples breastfeed without a shield by using pre-feed eversion techniques (pump suction, reverse pressure softening), breast shaping at the latch, and positions that give more control (like the football hold). A shield is only needed if these approaches don't achieve a consistent latch.