Kathy,

In answer to your student's question:

It has been my experience that the term "inverted nipples" is used quite
loosely, sometimes even to refer to nipples that retract on compression.
Therefore, the term itself can be quite misleading.

I discovered a reference that described two types of what I consider to
be truly inverted nipples: 1) Umbilicated, in which a fully formed nipple
is hidden in the pit, and 2)Invaginated, in which the skin that would
have developed into the surface skin of the nipple simply lines the pit
leading to deep milk sinuses, but there is no nipple per se at all.

Of the 5 or 6 cases I have attempted to follow with photos and
interventions, all but one were bilateral. Several mothers opted to
change their intentions and it was never determined whether they were
umbilicated or invaginated.

One mother had a unilateral invaginated nipple and one everted nipple.
She told me that her mother, her aunt and her grandmother each had
exactly the same situation, on the same side. She went on to BF
exclusively on the unaffected side for  four months and going strong when
I lost contact with her.

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio
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