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Sunday, May 06 2018

This is usually a tough experience for a new mum and her newborn. However there are a few techniques that can be implemented to help baby latch better. Most people with inverted nipple are usually unilateral, a small amount has bilateral inverted nipple.



1. Nipple stimulation: This is a technique that is done by using your thumb and index finger roll the nipple for 30sec and touch with a cold cloth right before offering the breast to your baby. This helps erect and evert the nipple.


2. Hoffman Technique: This is done to help loosen the adhesions at the base of the nipple. It can be done during pregnancy and after delivery for up to 5 times a day. Place the thumb of both hands on each side of the base of the nipple. Gently push in firmly against your breast tissue while at the same time pulling your thumbs away from each other. This stretches pit the nipple and loosen the tightness at the base which will make it move up and outward.


3. Breast Shells : For many years this was recommended for use from third trimester of pregnancy but research has shown that these don't make much of a difference. However, some mums claim it helped them. Basically, breast shells are small plastic that are worn inside the bra. The inner piece fits over the nipple and works by applying gentle but  constant pressure to the areola trying to break the adhesions under the skin so as to draw out the nipple. Worn for few hours per day while pregnant and 30mins before breastfeeding after delivery. Not to be worn at night.


4. Nipple Everter: This is a device that uses vacuum to gently draw out flat or inverted nipples making it easier for baby to latch and feed. Best to use prior to latching baby on and can be repeated multiple times during the day.


5. Breastpump: A well-fitted breastpump can be used to draw out a flat or inverted nipple immediately before breastfeeding to help make latch on easier for baby. Usually after the first few feedings the baby's constant sucking will help to further break the adhesions and help the nipple tissue to protrude.


6. Pulling back on the breast tissue during latch on: Using your hand with thumb on top and four fingers underneath, pull the breast tissue toward the chest wall. This will help the nipple to protrude.


7. Nipple Shield: This is a nipple shaped silicone  that is placed over the mothers nipple during feedings so that latch on is easier for baby. It has holes in it that allows baby to get milk while sucking. This can have a negative effect especially if baby becomes used to the shield and wouldn't want to try latching directly. So learn to remove the shield once baby is latching on and nursing well. Better to use this under the guidance of your healthcare provider. 


8. Surgery: This is when a nipple surgery is done to correct an inverted nipple. This carries a huge risk because if the milk ducts are affected during the surgery it will greatly affect breastfeeding. And for some mothers their nipple remain inverted even after the surgery. Also to note that some opt for nipple piercings which as with surgery can greatly damage the milk ducts and affect breastfeeding.


9. Exclusive Pumping: When you have tried all these and your baby is still not able to latch and stay on the breast, you will need to maintain demand on your breast by pumping to be able to provide breastmilk for your baby. 




•Start preparing yourself from pregnancy.

•Latch baby on within the first hour after delivery

•Get baby to open mouth wide to be able to grab a good mouthful of the breast

•If baby is upset . Take a break, soothe baby and try again

•Hand express to empty breast if engorged before attempting to latch baby

•Avoid prolonged use of artificial nipples to encourage baby to have preference for the breast

•Try different breastfeeding positions and find what makes you and baby more comfortable.

•Clean the nipple after feed and use nipple cream for soreness

•If the nipple inverts when baby pauses during feeding you will have to pump again or use nipple everter to protrude the nipple before offering it to baby again.


Remember PERSISTENCE AND PATIENCE is necessary. And nipple inversion tends to be better with the next baby. You are doing a great job and at the end of thr day what matters is a healthy well fed baby.



The Milk Booster

Posted by: Dr Chinny AT 12:30 pm   |  Permalink   |  0 Comments  |  Email
Sunday, May 06 2018
Postpartum Depression

As we have come to the end of Maternal Mental Health Awareness week 2018. These are the few things I will like you to remember as the life of a new mum and infant can be dependent on you. 


Firstly, a lot of people say they have postpartum depression when they only have signs of postpartum blues. 


During the postpartum period, about 85% of women experience some type of mood disturbance. Whereas only about 10-15% of women develop symptoms of depression or anxiety.


There are 3 types of Postpartum Mood Changes:



It's common for about 80% of mothers to experience postpartum blues during the first few weeks after delivery. This is considered normal. The symptoms usually peak on the 4th or 5th day postpartum and mostly resolves on its own by two weeks postpartum.

Symptoms include:

•crying for no reason 

•excessive fatigue







•frequent mood swings 

No treatment is required for this. But if it extends over two weeks visit your doctor as postpartum blues can lead to the development of a more significant mood disorder. 




This can start anytime postpartum but mostly around 2 to 3 months after delivery. If any new mum feels this way she needs proper investigation by her doctor. 

Symptoms include:


•feeling down

•crying for no reason 

•loss of interest in usual activities

•decreased libido

•feeling guilty

•feelings of worthlessness



•excessive fatigue

•difficulty sleeping 

•change in appetite

•poor concentration 

•suicidal thoughts

This gets worse if untreated.




This is the most severe of the three. Only occurs in 1-2 per 1000 women after childbirth. Can start as early as 48 to 72hrs postpartum. 

Symptoms include :




•rapid change in depressed or elated mood




•disorganized behaviour


•hallucinations (hearing and seeing things that aren't there)

•suicidal thoughts against self and infant

This is a MEDICAL EMERGENCY. Please visit your doctor for proper investigation.


Have you ever felt this way before? Please share.

Posted by: Dr Chinny AT 01:31 am   |  Permalink   |  0 Comments  |  Email

The Milk Booster was coined out of a desire to increase and have a good steady supply of breastmilk for my baby. I have always wanted to breastfeed my baby exclusively and imagined it will be a straightforward, easy journey. Read more

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