Sore Nipples


Breastfeeding is a learned skill for mothers. Like with learning any new skill, it can take some time to get the hang of breastfeeding.  It can take a little while to get used to the strong sucking of a healthy baby. In the early weeks, many mothers experience some nipple pain that ceases after the initial attachment. For most mothers, sore nipples cease to be a problem after the early weeks. Allowing your baby to self attach as often as possible while you both learn helps reduce the chance of getting damaged nipples. The most common reason for sore and damaged nipples is the baby’s poor attachment to the breast.

Here are some suggestions to help deal with sore nipples:

Before feeds:

  • Offer a feed before your baby starts crying, when your baby is showing early feeding cues.
  • Make yourself comfortable and relax as much as you can.
  • Massage your breasts gently and apply warmth to help get your milk flowing.
  • Express some milk to soften the areola to lubricate the nipple.

During feeds:

  • Offer the less sore side first.
  • Make sure baby is properly positioned at and attached to the breast.
  • Try different feeding positions.

If you wish, restrict comfort sucking while nipples are tender. Gently break suction with clean finger inserted in the corner of baby’s mouth before removing baby from the breast.

After feeds:

  • Check your nipples for signs of stress, such as red stripes or a squashed look.

  • Express a few drops of milk and smear on the nipple.

  • Leave your bra open for a few minutes until nipples are dry.

  • Keep nipples dry. Change nursing pads frequently. Consider washable nursing pads if disposable ones are chafing.

Avoid:

  • Using anything on your nipples that is drying or may damage your nipple skin (eg shampoo, rough towels).
  • Wearing poorly-fitted bras and plastic-backed nursing pads.
  • Using breast pumps that have strong suction and hurt your nipples. The Unimom Forte is the cheapest and best on the market and is great for pain free expressing!

There can be a few causes of sore or cracked nipples. Working out the cause is important, as this helps to find the right solution in your case.

In most cases, sore or cracked nipples are the result of incorrect positioning or attachment.

Sometimes the crack in the nipple skin can be seen on the nipple itself or where the nipple joins the areola, or the crack can be very fine and hard to see. Breastfeeding with a cracked nipple is often painful and cracked nipples may bleed during breastfeeds.

Please note: Although bleeding looks scary and blood may sometimes show up in your baby’s bowel motions or vomit, it is not harmful to your baby. It is quite safe for her to keep breastfeeding.

Things to do to help a cracked nipple:

  • Find the cause — poor positioning or attachment, medical problems such as infection or dermatitis on your nipples, or anatomical problems such as tongue-tie in your baby, or damage from incorrect use of breast pumps.
  • Follow the ideas for sore nipples.
  • You may need to take your baby off the sore breast for 12–24 hours to rest the nipple and allow healing to begin. In such a situation, you can express to maintain your supply, keep your breasts feeling comfortable and feed your baby your expressed breastmilk.
  • Start breastfeeding on the sore nipple again gradually, with short feeds. Feed your baby from the less-sore side first. Take special care with positioning and attachment.
  • Discuss with your LMC if you need pain relief or you suspect a medical cause.
  • Use a nipple shield only after seeing a Lactation Consultant.

Nipple tenderness is common for the first 7-10 days and peaks between day 3-6. If you are experiencing nipple pain after 14 days you should seek help.

Julia Daly