Some women experience sore nipples in the early weeks of breastfeeding. Some experts attribute early nipple soreness to hormonal changes and getting used to breastfeeding. Early pain may be considered normal as long as it passes and is not accompanied by cracks, bleeding, or other nipple trauma. It is described as tenderness during the latch-on and the first few sucks. It usually peaks in the first week after birth between days 3 and 6.
Latch, Positioning, and Suck ProblemsThe most common causes of sore nipples while breastfeeding is poor positioning or latch-on, especially in early days, and or improper sucking by the baby.
Sucking problems are commonly caused by a problem with the position or latch and usually a baby who is correctly latched-on to the breast well will also suck properly. The soreness caused by poor latching and ineffective suckling hurts most as you latch the baby on and usually improves as the baby feeds. Mothers describe the pain as "knife-like".
Get the baby to open wide and make sure that your baby is getting as much of your areola into his mouth as possible though not necessarily the whole areola.
DO NOT let the baby latch onto the nipple.
A baby properly latched on will be covering more of the areola with his lower lip than with the upper lip.
If your nipple hurts, after baby has latched-on, try using your finger to pull down on the baby's chin to bring the lower lip out. The pain will usually subside. Do not take the baby on and off to get the perfect latch.
If you take your on and off your breast and it hurts, you will have much more more pain and damage.
Correct the latch when putting him to the other breast, or at the next feeding.
Anatomy of the baby's mouth can attribute to soreness for example babies with unusual shapped palates or short frenulums - "tongue-tied". After a feed nipple may appear flattened and develop a crack.
Cracked NippleWhen causes of nipple pain are ignored or carried to the extreme, it may lead to a nipple injury or a crack. While your nipple heals, it may help to use lanolin ointment to lubricate the area. Lanolin acts as a "band-aid" or "plaster" to protect your nipples until it heals. Lansinoh Lanolin for Breastfeeding Mothers is the only topical ointment endorsed by La Leche League International. Lansinoh is hypoallergenic and completely natural, and does not have to be washed off before breastfeeding.
Thrush (Candida albicans)
Fungal or yeast infection may cause sore nipples.
Treatment of sore nipples caused by thrush.
Common signs and symptoms are itchy or burning nipples that appear pink or red, shiny, flaky, and may or may not have a rash with tiny blisters, cracked nipples, shooting pains in the breast during or after feedings, and/or nipple pain that doesn't improve with better positioning or correcting th baby's latch.
There are not always visual symptoms though it is sometimes accompanied by thrush in the baby's mouth that looks like white milk curd patches.
The pain from the fungal infection goes on throughout the feed and may continue even after the feed is over. The pain of the fungal infection is often described as deep breast pain that is intense and knife-like and burning and radiating, however not all women experience burning.
A new onset of nipple pain when feedings had previously been painless is a tip off that the pain may be due to a yeast infection, but the pain may be superimposed on pain due to other causes. Cracks may be due to a yeast infection.
A yeast infection may be a sign of another existing condition such as:Diabetes
Use of antibiotics
Use of steroids
Obesity or excessive sweating
Vaginal yeast infection
Use of Irritating Substances
Chapped and sore nipples can be caused by using irritating substances. Substances that may cause sore nipples:
soap Regular bathing or showering is enough to keep nipples clean and you do not need to use soap.
alcohol Products containing alcohol may cause dryness and be irritating to nipples.
lotions and ointments The use of some products have been found to cause contact dermatitis and hives in some women.
Skin conditions such as eczema, dermititis, psoriasis, and poison ivy may also cause late onset nipple pain.
EczemaItchy flaking skin may be due to eczema or another form of dermatitis that should be treated by a doctor.
A home remedy for mild nipple eczema is to immediately rinse nipples after feeding with a solution of bicarbonate soda dissolved in a pint of water.
Eczema on only one nipple that doesn’t respond to treatment may be an indication of a rare form of breast cancer, Paget’s Disease and should be brought to the attention of your doctor.
Compression Vasospasm and Raynaud's phenomenonAfter the baby finishes feeding, the nipple appears white.
The pain associated with blanching of the nipple is frequently described by mothers as burning, but generally begins only after the feeding is over. It usually lasts for a few minutes before the nipple returns to its usual color and often the nipple pain develops into what mothers describe as throbbing.
This is caused by the blood vessels constricting and then relaxing. This type of pain may continue only after the feed and not during it.
It is most important to correct positioning and latch. In many cases, the problem of nipple soreness ends there.
Applying heat right after nursing may prevent or decrease the pain. Use a warm washcloth or water bottle.
Other Reasons for Sore Nipples
Wearing a bra that is too tightCompression of the nipple can be the painful result of wearing a bra that is too tight. Bras with seams may rub and irritate nipples.
TeethingA baby who is teething may gain comfort in chewing or biting down on the nipple at the end of a feed. Firmly tell your baby that biting hurts you and try end the feed before your baby resorts to biting. Offer a soothing teething ring or cloth for your baby to teeth on.
Improper use of breast pump
Hormonal changes due to pregnancyTender nipples during pregnancy are caused by hormonal changes and may be the first sign of pregnancy. Some women experience soreness in the 1st trimester and others continue to have sore nipples throughout their pregnancies.
For some breastfeeding moms, sore nipples are a reason to wean. Mothers who choose to continue breastfeeding regardless of their discomfort learn to cope with the tenderness in various ways. Some of the suggestions pregnant, nursing moms have made are:
Talk to your nursing baby or toddler. Explain and ask them to be gentle or to nurse for shorter periods. Reassure them that they are not to blame for your discomfort.
Try nursing in different positions.
Use relaxation and breathing techniques.
Make your milk flow with hand expression before your baby or toddler latches on.
Sore Nipples ~ Troubleshooting Chart
Nipples ShieldsNipple shields are not recommended for sore nipples as they often do not help and they may cause other problems like lowering milk supply.
Last ResortIf you are unable to put the baby to the breast because of pain, a 3-5 day break from breastfeeding may be helpful while giving nipples time to heal.
During this time, it is helpful if your baby is not fed with an
. It is best for you and your baby if the baby is fed expressed milk.
This is a last resort and taking a baby off the breast should not be taken lightly and, it often doesn’t work.