The Scenario: Some years ago your friend went to a studio, lifted her shirt, and a tatted man armed with a sterile needle bedazzled her nipple for good. That piercing has given her lots of love over the years, but now she's looking forward to motherhood and worries the bling will get in the way of breastfeeding.
The Facts: First, an anatomy refresher: A woman's nipple is surrounded by the areola, and both are riddled with nerves and ducts that "go in a radial spoke-like fashion out from the nipple," says Pamela Berens, an OB/GYN at University of Texas Physicians. Both play vital roles in nursing.
When a baby latches onto the nipple, the nerves send impulses to the brain that trigger the release of the prolactin hormone in your pituitary gland, which tells your mammary glands to produce breast milk. Myoepithelial cells in the mammary gland contract, moving the milk into the nipple, through the ducts, and into the baby's mouth.
Most mothers in the United States—81.1 percent—breastfeed their babies at birth, and 51.8 percent are still breastfeeding at six months, according to the latest data from the Centers for Disease Control and Prevention. And the benefits seem endless: Research shows it can protect babies from asthma, diversify their gut microbiome, and help them live longer. Breastfeeding also protects the mother from Type 2 diabetes, ovarian cancer, and breast cancer. But can a nipple piercing stand in the way?
The Worst That Can Happen: If your friend has noticed complete nipple numbness since getting it bejeweled, it's likely the nerves won't send those initial signals to the brain. "If you don't get nipple stimulation, you don't get that same kind of repeated boost to your prolactin and it can diminish your milk supply," Berens says.
But the risk of complete nerve damage is low. More risky are breast augmentations and reductions with periareolar incisions. The two- to three-centimeter incision around the areola severs many more nerves and ducts than the tiny, two-millimeter piercing through the nipple.
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What'll Probably Happen: Some of your friend's many, many nerves are probably damaged, but likely not enough to shut down the signals to her brain. Each nipple has about 20 ducts, some of which may become blocked—especially if she scarred badly or her piercing got infected—which can interfere with the supply-and-demand system of breastfeeding. The body will stop producing milk for a duct that isn't releasing the milk, but other ducts can compensate for that so the baby still gets enough, Berens says.
A nipple piercing could also cause a quirk in her let-down reflex, which causes a nursing mother to lactate when she hears a baby cry even if she's not breastfeeding at that moment. "I've had some women with piercings say, you know, that it kind of goes in a funny direction," Berens says. But that's not really a problem—just an oddity.
She may also leak out of the pierced nipple while nursing with the other breast. "It's a new passage," says Susan Crowe, a clinical associate professor of obstetrics and gynecology at Stanford University. "Instead of the milk having to come out through the duct, it could just come out through the hole that was created with the piercing."
What Your Friend Should Do: Unless there's irreversible nerve damage, your friend can mitigate the risk of low milk supply by breastfeeding her baby early and often—eight to twelve times a day to start, Berens says. (And don't forget, if she has only one nipple pierced, she can always use the other breast for feeding.) Even with some nerves and ducts out of commission, her body will learn how much milk the baby needs if she follows the baby's feeding cues.
She should take her piercing out before feeding—it's a choking hazard and it can make it hard for a baby to latch on—and skip the disinfecting wash. "Breast milk is interestingly very antimicrobial," Crowe says. "It can help with the cleansing and maintenance at the site of the piercing." If she has trouble, she shouldn't give up. International board certified lactation consultants (IBCLCs) can help her in her breastfeeding efforts.
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