You had your nipple pierced some years ago. Now you're pregnant or breastfeeding, and you can't find a truly comprehensive answer to your questions anywhere. Generalist websites contradict each other.

This article won't just tell you "it's possible in most cases." It will explain why, how, and under what conditions nipple piercing can affect your breastfeeding journey.

Our answers come from two sources: scientific literature and practical experience.
Through Madame Tire-Lait training and our community, we have supported over 5,000 pumping mothers. Among them, dozens had a history of nipple piercing and faced very diverse situations that general articles don't prepare you for.

THE ESSENTIALS

A piercing does not compromise milk production (glands behind the nipple)
It can sever 1 or more milk ducts, creating an internal scar
Removed during pregnancy/postpartum: milk can leak through the holes
This phenomenon is harmless but requires adaptations (nursing, pump)
Garbin et al. JAMA 2009 (460 women): piercing = risk factor for low production

WHAT THE PIERCING GOES THROUGH: NIPPLE ANATOMY

A nipple contains an average of 7 to 12 milk ducts that converge towards its tip. Ramsay et al. (2005, PLOS ONE): 4 to 9 functional pores in a primiparous woman.
When a piercing is inserted, the bar passes straight through the tissue. Depending on its diameter and depth, it can sever 1, 2, or more ducts. The body heals by forming a fibrous tract (fistula) around the jewelry.
This tract can partially obstruct adjacent ducts. In most cases, the remaining ducts compensate. But if several are affected, the accessible milk volume may be reduced.
→ Sources: ScienceDirect Topics, Nipple Piercing; Zucca-Matthes G et al. Anatomy of the nipple and breast ducts. Gland Surgery 2016;5(1):32-36. doi:10.3978/j.issn.2227-684X.2015.05.10

PIERCING AND MILK PRODUCTION

Milk production relies on prolactin and oxytocin, released by the pituitary gland in response to nerve stimulation of the nipple. If a piercing damages nerve endings, this signal can be attenuated.
KEY STUDY: Garbin CP, Deacon JP, Rowan MK, Hartmann PE, Geddes DT. "Association of nipple piercing with abnormal milk production and breastfeeding." JAMA. 2009;301(24):2550-1. [PubMed: 19549971] → Among 460 breastfeeding women, nipple piercing is identified as a risk factor for insufficient production. However, most pierced women breastfeed without notable insufficiency.

LactMed® (NIH, 2025): piercing does not seem to interfere with lactation in most cases, but is a risk factor for insufficiency and cases of ductal obstruction have been documented. → https://www.ncbi.nlm.nih.gov/books/NBK500564/

MILK LEAKING THROUGH THE HOLES: NORMAL OR CONCERNING?

When the piercing is removed during pregnancy or just after childbirth, the holes left behind become integrated into the developing ductal network. Milk can flow through these additional pathways during feeding or pumping.
Not dangerous. Milk is still milk. ScienceDirect Topics (Physician Guide to Breastfeeding) confirms: "Milk will indeed pass through the piercing sites; however, this does not negatively affect milk production or extraction."

In Madame Tire-Lait training, this phenomenon regularly comes up in testimonials: mothers who are alarmed to see milk escaping "from the sides" during pumping, without understanding why. This is not a pump malfunction. It's their nipple anatomy speaking.

IMPACT ON NURSING

Lateral leakage = unexpected flow for baby managing centered sucking. Can cause: coughing/choking | frequent unlatching | frustration.
Practical advice: → Manually trigger the let-down reflex before offering the breast → Reclined position (biological nurturing) to slow the flow by gravity → Adaptation in a few days to a few weeks for most babies

PUMP AND PIERCING: ADAPTING YOUR FLANGE

A standard flange can obstruct the lateral piercing holes and block some of the flow → disappointing pumped volumes.
Solution: test a LUPA flange slightly larger than the usual size → to leave space around the base of the nipple without blocking the holes.
This is one of the adjustments we cover in Madame Tire-Lait training (https://www.madametirelait.com/formation): flange size is not a fixed data point. It adapts to the actual anatomy of each nipple, and in the case of a previous piercing, this adaptation is even more crucial.
Stimulation: target the BASE of the nipple (not just the tip) to trigger the let-down reflex through the main ducts.

REAL RISKS

Ductal obstruction / mastitis: scar tissue can compress adjacent ducts. InfantRisk Center: cases of obstruction linked to piercing documented in the literature.
Delayed subareolar abscess: published clinical cases of deep infectious complications during lactation, along the scar tract. → Source: ScienceDirect Topics, Nipple Piercing
Reversible hyperprolactinemia: Modest & Fangman (NEJM 2002) and Demirtas et al. (Dermatol Surg 2004): rare cases linked to infection. Disappears with treatment.

WHEN TO REMOVE THE PIERCING?

Removed well before pregnancy → complete healing → minimal impact. Removed during pregnancy → holes integrated into the developing network. Recommendation: removal at the beginning of pregnancy (1st trimester).

PRACTICAL ADVICE

Before birth: inform your midwife and IBCLC about the piercing history. In the delivery room: observe the 1st let-down reflex (lateral leakage?). For the breast pump: if milk leaks from the sides, try a larger size. For nursing: semi-reclined position at the start of the session. Monitoring: localized redness + fever = prompt consultation.
If difficulties persist: Madame Tire-Lait training supports pumping mothers, including those with complex anatomical situations. It is a reference resource for going beyond general advice.


SOURCES ARTICLE 1 (10 references) [1] Garbin CP et al. JAMA 2009;301:2550-1. PubMed: 19549971 [2] LactMed® NIH 2025. NBK500564. ncbi.nlm.nih.gov/books/NBK500564/ [3] Modest GA, Fangman JJ. N Engl J Med 2002;347:1626-7. PubMed: 12432057 [4] Roche-Paull R. J Hum Lact 2015;31:552-3. PubMed: 26185213 [5] Zucca-Matthes G et al. Gland Surgery 2016;5(1):32-36. [6] Jin X et al. Nutrients 2025;17:3524. PMC12655712 [7] ScienceDirect Topics, Nipple Piercing (medical literature review) [8] Physician Guide to Breastfeeding, Plastic Surgery 2025 [9] InfantRisk Center, Nipple Piercing Effects [10] La Leche League France, Piercing et allaitement