Large Nipples, Small Baby

By Krista Gray, IBCLC. Last updated October 9, 2013.

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Nipples and breasts, just like babies, come in all sorts of shapes and sizes; rarely does nature mix up babies and breasts. However, when a mother has exceptionally long nipples and a baby is very small, it may take time for a baby to grow into her mother’s nipples. Statistically speaking, long nipples are less of a breastfeeding concern than inverted nipples.1 Nonetheless, large nipples can be a cause excessive weight loss and/or slow weight gain in the first week following birth. 2

What breastfeeding challenges can large nipples present?
Extra long nipples with an accompanying small baby can cause an infant to gag and then slide off the nipple to cope with its length. This poor latch can cause milk supply issues and breastfeeding pain for a mother as well as allow her baby to learn a lazy attachment at the breast. A newborn may learn to have a shallow latch while nursing which could then continue even when he grows bigger and the size of his mother’s nipples would not prevent him from actually latching much deeper. This shallow latch could impact a mother and baby negatively in a variety of ways:

  • Poor latch can decrease a mother’s milk supply. This is especially of concern in the beginning days/weeks of lactation when a mother’s milk supply is being established.
  • Poor latch can cause pain. Sore and cracked nipples can make a mother more likely to supplement or wean her baby altogether.
  • A shallow latch can cause slow weight gain or even failure to thrive in baby.
  • A shallow latch in a baby can mimic bottle feeding and limit breastfeeding’s effects of proper oral-facial development.
  • A shallow latch can be harder to correct later when a baby does grow into her mother’s nipples.

What can I do if large nipples are a concern?

First, it is important to have your baby’s oral anatomy checked. There could be a tongue tie, lip tie, hypertonia, cleft, or other developmental variation that is affecting how deep of a latch your baby has on your breast. Sometimes these can be easily corrected and allow your newborn to quickly breastfeed better.

If your baby’s oral anatomy is normal then it may be a matter of protecting your milk supply until your baby grows and is able to latch properly. There are several steps to take to protect/build your supply:

  1. If your baby’s weight gain is not adequate and/or she does not have enough wet and dirty diapers/nappies then you will need to pump your breasts following each feed. If your baby struggles to latch and suckle, you can then top off your baby with this expressed milk (or, alternatively, give it as the “appetizer”). This should help your baby gain strength and energy and give her time to grow into your nipples.
  2. Make sure to take necessary steps to protect yourself from developing sore or cracked nipples.
  3. Some mothers may need to exclusively pump in the beginning to build their supply, protect their nipples from pain and cracking, and give their babies time to grow.
  4. Make sure to spend as much time as you can skin-to-skin with your baby. You may want to carry your baby in a wrap or sling, take a bath together, or hold her this way even when giving a bottle. Skin-to-skin promotes bonding, growth in baby, and a mother’s milk supply. If she spontaneously tries to suckle at times, let her! In fact, continue to offer to breastfeed at your breasts as much as possible so that the transition to exclusive breastfeeding can be smooth.

The important thing to remember about large nipples and a small baby is that this is temporary. Babies grow very quickly and your baby will grow into your breasts. Large nipples do not make breastfeeding impossible but having lactation support in the beginning is essential.

Show 2 footnotes

  1. Riordan J. & Wambach, K. Breastfeeding and Human Lactation, 4th ed. Sudbury, MA: Jones and Bartlett Publishers.
  2. Vazirinejadl, Reza. (2009). The effect of maternal breast variations on neonatal weight gain in the first seven days of life. International Breastfeeding Journal 4:13.
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