37:
1441:
200:
236:
often can drink at the breast, and milk production is not affected; after breastfeeding, nipples often are less or no longer inverted. Women with grade-3 inverted nipples may also struggle with infections, rashes, or problems with nipple hygiene. The fibrosis is remarkable and lactiferous ducts are short and severely retracted. The bulk of soft tissue is markedly insufficient in the nipple. Histologically,
63:
235:
Inverted nipple grade 3 describes a severely inverted and retracted nipple which can rarely be pulled out physically and which requires surgery to be protracted. Milk ducts are often constricted, and breast feeding is difficult, but not necessarily impossible. With good preparation and help, babies
227:
Inverted nipple grade 2 is the nipple which can be pulled out, though not as easily as the grade 1, but which retracts after pressure is released. Breast feeding is usually possible, though it is more likely to be hard to get the baby to latch comfortably in the first weeks after birth; extra help
223:
Inverted nipple grade 1 refers to nipples that can easily be pulled out, by using finger pressure around the areola. The grade-1 inverted nipple maintains its projections and rarely retracts. Also, grade-1 inverted nipples may occasionally pop up without manipulation or pressure. Milk ducts are
252:. Most women with inverted nipples who give birth are able to breastfeed without complication, but inexperienced mothers may experience higher than average pain and soreness when initially attempting to breastfeed. When a mother uses proper breastfeeding technique, the infant latches onto the
224:
usually not compromised and breast feeding is possible. These are "shy nipples". It is believed to have minimal or no fibrosis. There is no soft-tissue deficiency of the nipple. The lactiferous duct should be normal without any retraction.
288:, may also cause inverted nipples to protract or stay protracted longer. Some special devices are specifically designed to draw out inverted nipples, or a home-made nipple protractor can be constructed out of a 10-ml disposable
228:
may be needed. Grade 2 nipples have a moderate degree of fibrosis. The lactiferous ducts are mildly retracted, but do not need to be cut for the release of fibrosis. On histological examination, these nipples have rich
749:
448:
429:
168:
742:
264:
or other suction device immediately before a feeding may help to draw out inverted nipples. A hospital grade electric pump may be used for this purpose. Some women also find that using a
735:
1446:
276:
Other strategies for protracting inverted nipples include regularly stimulating the nipples to a protruding state, in an attempt to gradually loosen the nipple tissue. Some
307:. Although it may be promoted, a 1992 study found that not only do shells not promote more successful breastfeeding, but they may also actually disrupt it.
1000:
268:
can help facilitate breastfeeding. Frequent stimulation such as sexual intercourse and foreplay (such as nipple sucking) also helps the nipple protract.
1342:
491:
324:
292:. These methods are often used in preparation for breastfeeding, which can sometimes cause inverted nipples to become protracted permanently.
248:
Women with inverted nipples may find that their nipples protract (come out) temporarily or permanently during pregnancy, or as a result of
303:
to try to break any adhesions under the skin that are preventing the nipple from being drawn out. The shells are worn inside the
980:
947:
680:
484:
995:
86:. In some cases, the nipple will be temporarily protruded if stimulated. Both women and men can have inverted nipples.
1398:
1253:
1180:
875:
1425:
477:
123:
1046:
784:
351:"Randomized controlled trial of breast shells and Hoffman's exercises for inverted and non-proctractile nipples"
927:
212:
The three grades of inverted nipples are defined on how easily the nipple may be protracted and the degree of
1129:
265:
1413:
1196:
1041:
328:
1209:
727:
256:, not the nipple, so women with inverted nipples are actually able to breastfeed without any problem. An
189:
Most common nipple variations that women are born with are caused by short ducts or a wide areola muscle
1320:
1119:
1093:
829:
775:
584:
128:
1357:
1347:
1265:
1165:
1468:
883:
1282:
1204:
962:
401:
1403:
1377:
1155:
975:
970:
942:
919:
819:
579:
524:
1367:
1362:
814:
519:
1372:
1241:
1136:
957:
932:
138:
8:
1408:
1352:
1246:
1175:
1160:
1141:
990:
804:
644:
591:
452:
1382:
1337:
1312:
1277:
1124:
1114:
809:
574:
569:
529:
375:
350:
457:
1287:
1259:
1219:
1214:
1149:
1023:
824:
799:
767:
380:
49:
1170:
1109:
841:
711:
632:
370:
362:
109:
36:
1473:
1325:
1292:
1081:
1066:
846:
665:
156:
1420:
1330:
1226:
1086:
1075:
1015:
893:
716:
622:
564:
500:
260:
that latches on well may be able to slush out an inverted nipple. The use of a
442:
438:
366:
1462:
1302:
1272:
1005:
888:
249:
162:
406:
1297:
1231:
701:
637:
596:
296:
285:
281:
183:
175:
757:
384:
1236:
985:
937:
870:
851:
836:
706:
675:
670:
660:
606:
601:
559:
549:
261:
229:
421:
856:
763:
217:
54:
900:
759:
304:
299:. Breast shells may be used to apply gentle constant pressure to the
190:
118:
196:
Inverted nipples can also occur after sudden and major weight loss.
794:
514:
237:
216:
existent in the breast, as well as the damage it has caused on the
213:
199:
146:
102:
1099:
554:
469:
289:
277:
1103:
696:
433:
300:
257:
253:
83:
79:
62:
1062:
1033:
866:
1001:
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
240:
terminal duct lobular units and severe fibrosis are seen.
101:
Trauma which can be caused by conditions such as fat
82:, instead of pointing outward, is retracted into the
411:
94:
The most common causes of nipple inversion include:
295:One methods which is now discouraged is the use of
232:stromata with numerous bundles of smooth muscle.
1343:Childbirth-related post-traumatic stress disorder
203:Grade-3 inverted nipples of a 23-year-old female.
1460:
271:
243:
743:
485:
550:Adipomastia (lipomastia, pseudogynecomastia)
750:
736:
492:
478:
153:Genetic variant of nipple shape, such as:
35:
374:
349:Alexander, JM; et al. (April 1992).
348:
280:designed for nipple stimulation, such as
198:
61:
1461:
169:Kennerknecht-Sorgo-Oberhoffer syndrome
981:Intrahepatic cholestasis of pregnancy
948:Intrahepatic cholestasis of pregnancy
731:
681:Pseudoangiomatous stromal hyperplasia
473:
1047:Pregnancy-induced hypercoagulability
135:Breast infections or inflammations
13:
996:Pruritic folliculitis of pregnancy
499:
14:
1485:
1254:Pain management during childbirth
1181:Twin-to-twin transfusion syndrome
395:
317:
207:
1440:
1439:
1426:Sexual activity during pregnancy
325:"Correction of Inverted Nipples"
105:, scars, or a result of surgery
928:Acute fatty liver of pregnancy
342:
1:
1130:Prelabor rupture of membranes
310:
44:Inverted versus normal nipple
1409:Systemic lupus erythematosus
1060:Maternal care related to the
1042:Gestational thrombocytopenia
108:Breast sagging, drooping or
7:
1210:Cephalopelvic disproportion
272:Other corrective strategies
244:Pregnancy and breastfeeding
78:) is a condition where the
10:
1490:
1321:Breastfeeding difficulties
1120:Constriction ring syndrome
1094:Braxton Hicks contractions
402:Inflammatory Breast Cancer
129:Inflammatory breast cancer
1434:
1391:
1358:Peripartum cardiomyopathy
1348:Pubic symphysis diastasis
1311:
1195:
1059:
1032:
1014:
956:
918:
909:
865:
783:
774:
689:
653:
615:
540:
507:
415:
367:10.1136/bmj.304.6833.1030
89:
48:
43:
34:
26:
21:
884:Gestational hypertension
1283:Umbilical cord prolapse
1205:Amniotic fluid embolism
963:dermatoses of pregnancy
585:Chronic cystic mastitis
355:British Medical Journal
161:Congenital disorder of
1399:Concomitant conditions
1378:Postpartum thyroiditis
1156:Circumvallate placenta
976:Impetigo herpetiformis
971:Gestational pemphigoid
943:Hyperemesis gravidarum
876:hypertensive disorders
580:Duct ectasia of breast
525:Granulomatous mastitis
204:
67:
1368:Postpartum infections
1363:Postpartum depression
541:Physiological changes
520:Nonpuerperal mastitis
202:
65:
1373:Postpartum psychosis
1242:Obstetrical bleeding
1137:Obstetrical bleeding
958:Integumentary system
933:Gestational diabetes
912:related to pregnancy
910:Other, predominantly
180:Recurrent infections
139:Mammary duct ectasia
1353:Postpartum bleeding
1176:Placental abruption
1161:Monochorionic twins
991:Prurigo gestationis
645:Nipple pigmentation
592:Dense breast tissue
407:Inversion of Nipple
98:Born with condition
1383:Puerperal mastitis
1338:Breast engorgement
1125:Monoamniotic twins
1115:Chorionic hematoma
575:Breast hypertrophy
570:Breast engorgement
530:Subareolar abscess
205:
76:invaginated nipple
68:
30:invaginated nipple
1456:
1455:
1414:Thyroid disorders
1404:Diabetes mellitus
1288:Uterine inversion
1220:Shoulder dystocia
1215:Obstructed labour
1191:
1190:
1055:
1054:
1024:Chorea gravidarum
800:Ectopic pregnancy
725:
724:
467:
466:
60:
59:
16:Medical condition
1481:
1443:
1442:
1278:Postmature birth
1266:Placenta accreta
1171:Placenta praevia
1166:Placenta accreta
1110:Chorioamnionitis
920:Digestive system
916:
915:
842:Fetal resorption
830:Rudimentary horn
787:abortive outcome
781:
780:
752:
745:
738:
729:
728:
633:Nipple discharge
494:
487:
480:
471:
470:
413:
412:
389:
388:
378:
361:(6833): 1030–2.
346:
340:
339:
337:
336:
327:. Archived from
321:
66:Inverted Nipples
39:
19:
18:
1489:
1488:
1484:
1483:
1482:
1480:
1479:
1478:
1469:Breast diseases
1459:
1458:
1457:
1452:
1430:
1387:
1331:Cracked nipples
1326:Low milk supply
1307:
1293:Uterine rupture
1187:
1082:Oligohydramnios
1067:amniotic cavity
1061:
1051:
1028:
1010:
961:
952:
911:
905:
874:
861:
847:Molar pregnancy
786:
770:
756:
726:
721:
685:
666:Breast hematoma
649:
628:Inverted nipple
623:Cracked nipples
611:
542:
536:
503:
498:
468:
463:
462:
424:
398:
393:
392:
347:
343:
334:
332:
323:
322:
318:
313:
274:
246:
210:
165:type 1A and 1 L
157:Weaver syndrome
124:Paget's disease
92:
72:inverted nipple
17:
12:
11:
5:
1487:
1477:
1476:
1471:
1454:
1453:
1451:
1450:
1435:
1432:
1431:
1429:
1428:
1423:
1421:Maternal death
1418:
1417:
1416:
1411:
1406:
1395:
1393:
1389:
1388:
1386:
1385:
1380:
1375:
1370:
1365:
1360:
1355:
1350:
1345:
1340:
1335:
1334:
1333:
1328:
1317:
1315:
1309:
1308:
1306:
1305:
1300:
1295:
1290:
1285:
1280:
1275:
1270:
1269:
1268:
1256:
1251:
1250:
1249:
1239:
1234:
1229:
1227:Fetal distress
1224:
1223:
1222:
1212:
1207:
1201:
1199:
1193:
1192:
1189:
1188:
1186:
1185:
1184:
1183:
1178:
1173:
1168:
1163:
1158:
1146:
1145:
1144:
1134:
1133:
1132:
1127:
1122:
1117:
1112:
1096:
1091:
1090:
1089:
1087:Polyhydramnios
1084:
1076:amniotic fluid
1071:
1069:
1057:
1056:
1053:
1052:
1050:
1049:
1044:
1038:
1036:
1030:
1029:
1027:
1026:
1020:
1018:
1016:Nervous system
1012:
1011:
1009:
1008:
1003:
998:
993:
988:
983:
978:
973:
967:
965:
954:
953:
951:
950:
945:
940:
935:
930:
924:
922:
913:
907:
906:
904:
903:
898:
897:
896:
894:HELLP syndrome
886:
880:
878:
863:
862:
860:
859:
854:
849:
844:
839:
834:
833:
832:
827:
822:
817:
812:
807:
797:
791:
789:
785:Pregnancy with
778:
772:
771:
755:
754:
747:
740:
732:
723:
722:
720:
719:
714:
709:
704:
699:
693:
691:
687:
686:
684:
683:
678:
673:
668:
663:
657:
655:
651:
650:
648:
647:
642:
641:
640:
630:
625:
619:
617:
613:
612:
610:
609:
604:
599:
594:
589:
588:
587:
582:
572:
567:
565:Breast atrophy
562:
557:
552:
546:
544:
543:and conditions
538:
537:
535:
534:
533:
532:
527:
517:
511:
509:
505:
504:
501:Breast disease
497:
496:
489:
482:
474:
465:
464:
461:
460:
445:
425:
420:
419:
417:
416:Classification
410:
409:
404:
397:
396:External links
394:
391:
390:
341:
315:
314:
312:
309:
273:
270:
245:
242:
209:
208:Grading system
206:
187:
186:
181:
178:
173:
172:
171:
166:
159:
151:
150:
149:
144:
143:Breast abscess
141:
133:
132:
131:
126:
121:
114:Breast cancer
112:
106:
99:
91:
88:
74:(occasionally
58:
57:
52:
46:
45:
41:
40:
32:
31:
28:
24:
23:
15:
9:
6:
4:
3:
2:
1486:
1475:
1472:
1470:
1467:
1466:
1464:
1449:
1448:
1444:
1437:
1436:
1433:
1427:
1424:
1422:
1419:
1415:
1412:
1410:
1407:
1405:
1402:
1401:
1400:
1397:
1396:
1394:
1390:
1384:
1381:
1379:
1376:
1374:
1371:
1369:
1366:
1364:
1361:
1359:
1356:
1354:
1351:
1349:
1346:
1344:
1341:
1339:
1336:
1332:
1329:
1327:
1324:
1323:
1322:
1319:
1318:
1316:
1314:
1310:
1304:
1303:Uterine atony
1301:
1299:
1296:
1294:
1291:
1289:
1286:
1284:
1281:
1279:
1276:
1274:
1273:Preterm birth
1271:
1267:
1264:
1263:
1262:
1261:
1257:
1255:
1252:
1248:
1245:
1244:
1243:
1240:
1238:
1235:
1233:
1230:
1228:
1225:
1221:
1218:
1217:
1216:
1213:
1211:
1208:
1206:
1203:
1202:
1200:
1198:
1194:
1182:
1179:
1177:
1174:
1172:
1169:
1167:
1164:
1162:
1159:
1157:
1154:
1153:
1152:
1151:
1147:
1143:
1140:
1139:
1138:
1135:
1131:
1128:
1126:
1123:
1121:
1118:
1116:
1113:
1111:
1108:
1107:
1106:
1105:
1101:
1097:
1095:
1092:
1088:
1085:
1083:
1080:
1079:
1078:
1077:
1073:
1072:
1070:
1068:
1064:
1058:
1048:
1045:
1043:
1040:
1039:
1037:
1035:
1031:
1025:
1022:
1021:
1019:
1017:
1013:
1007:
1006:Stretch marks
1004:
1002:
999:
997:
994:
992:
989:
987:
984:
982:
979:
977:
974:
972:
969:
968:
966:
964:
959:
955:
949:
946:
944:
941:
939:
936:
934:
931:
929:
926:
925:
923:
921:
917:
914:
908:
902:
899:
895:
892:
891:
890:
889:Pre-eclampsia
887:
885:
882:
881:
879:
877:
872:
868:
864:
858:
855:
853:
850:
848:
845:
843:
840:
838:
835:
831:
828:
826:
823:
821:
818:
816:
813:
811:
808:
806:
803:
802:
801:
798:
796:
793:
792:
790:
788:
782:
779:
777:
773:
769:
765:
761:
758:Pathology of
753:
748:
746:
741:
739:
734:
733:
730:
718:
715:
713:
710:
708:
705:
703:
700:
698:
695:
694:
692:
688:
682:
679:
677:
674:
672:
669:
667:
664:
662:
659:
658:
656:
652:
646:
643:
639:
636:
635:
634:
631:
629:
626:
624:
621:
620:
618:
614:
608:
605:
603:
600:
598:
595:
593:
590:
586:
583:
581:
578:
577:
576:
573:
571:
568:
566:
563:
561:
558:
556:
553:
551:
548:
547:
545:
539:
531:
528:
526:
523:
522:
521:
518:
516:
513:
512:
510:
506:
502:
495:
490:
488:
483:
481:
476:
475:
472:
459:
455:
454:
450:
446:
444:
440:
436:
435:
431:
427:
426:
423:
418:
414:
408:
405:
403:
400:
399:
386:
382:
377:
372:
368:
364:
360:
356:
352:
345:
331:on 2010-03-27
330:
326:
320:
316:
308:
306:
302:
298:
297:breast shells
293:
291:
287:
283:
279:
269:
267:
266:nipple shield
263:
259:
255:
251:
250:breastfeeding
241:
239:
233:
231:
225:
221:
219:
215:
201:
197:
194:
192:
185:
182:
179:
177:
174:
170:
167:
164:
163:glycosylation
160:
158:
155:
154:
152:
148:
145:
142:
140:
137:
136:
134:
130:
127:
125:
122:
120:
116:
115:
113:
111:
107:
104:
100:
97:
96:
95:
87:
85:
81:
77:
73:
64:
56:
53:
51:
47:
42:
38:
33:
29:
25:
20:
1445:
1438:
1298:Vasa praevia
1258:
1232:Locked twins
1148:
1098:
1074:
820:Interstitial
702:Fat necrosis
638:Galactorrhea
627:
597:Gynecomastia
508:Inflammation
447:
428:
358:
354:
344:
333:. Retrieved
329:the original
319:
294:
282:suction cups
275:
247:
234:
226:
222:
211:
195:
188:
184:Tuberculosis
176:Gynecomastia
93:
75:
71:
69:
1237:Nuchal cord
986:Linea nigra
938:Hepatitis E
871:proteinuria
852:Miscarriage
837:Embryo loss
815:Heterotopic
676:Galactocele
671:Breast lump
661:Breast cyst
607:Micromastia
602:Mammoplasia
560:Anisomastia
262:breast pump
230:collagenous
27:Other names
1463:Categories
1247:Postpartum
1142:Antepartum
857:Stillbirth
768:puerperium
766:, and the
764:childbirth
335:2010-04-05
311:References
218:milk ducts
55:Gynecology
1313:Puerperal
901:Eclampsia
805:Abdominal
776:Pregnancy
760:pregnancy
191:sphincter
119:carcinoma
50:Specialty
1447:Category
1260:placenta
1150:placenta
810:Cervical
795:Abortion
515:Mastitis
278:sex toys
238:atrophic
214:fibrosis
147:Mastitis
103:necrosis
1100:chorion
825:Ovarian
717:Tension
555:Amastia
385:1586788
376:1881748
290:syringe
117:Breast
1474:Nipple
1104:amnion
712:Ptosis
697:Amazia
654:Masses
616:Nipple
383:
373:
301:areola
286:clamps
258:infant
254:areola
110:ptosis
90:Causes
84:breast
80:nipple
22:nipple
1392:Other
1197:Labor
1063:fetus
1034:Blood
873:, and
867:Edema
690:Other
458:611.8
443:O92.0
439:N64.5
1065:and
707:Pain
453:9-CM
381:PMID
449:ICD
430:ICD
371:PMC
363:doi
359:304
305:bra
284:or
70:An
1465::
1102:/
869:,
762:,
456::
441:,
437::
434:10
379:.
369:.
357:.
353:.
220:.
193:.
960:/
751:e
744:t
737:v
493:e
486:t
479:v
451:-
432:-
422:D
387:.
365::
338:.
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