It’s normal for a new breastfeeding mother to experience nipple soreness or discomfort. This usually will occur in the first few weeks of nursing during the first few minutes of when your baby latches. If you continue to have pain and soreness, it could be due to traumatized or irritated nipples.
Traumatized vs. Irritated
There are two reasons you may experience nipple pain and soreness. Traumatized nipples refer to nipples that may be damaged from latching issues. These nipples may be blistered, scabbed, or cracked. This may be from faulty sucking by your baby, tongue-tie issues, or thrush. Damage can also come if your baby has an exceptionally strong suck or stretches and pulls the nipple when latching or unlatching.
Irritated nipples often have a bright pink or slightly red appearance and will burn when nursing. Irritated nipples usually are caused by thrush, other bacterial infections, chemical sensitivities or allergies, and some skin conditions. You should always be washing breast pump parts, bottles, and breast shells several times a day to avoid bacteria growth. Bras and other clothing that touches your nipples should be cleaned and thoroughly rinsed to prevent chemical residue from irritating your nipples.
Treatment for Sore Nipples
The first thing to do in treating sore nipples is to figure out what is causing the soreness and pain. If it is your baby’s latch you should seek help, ideally from a trained lactation consultant, to help you ensure your baby is getting a deep latch and minimizing nipple damage. Make sure that your baby is taking enough breast tissue into their mouth so that they are not clamping down on just your nipple. Also, check your baby’s tongue positioning. If you are experiencing flat or inverted nipples that can lead to a latch that is not deep enough to be comfortable. There are steps you can take to help your baby achieve a deeper latch.
Take Tylenol thirty minutes before nursing and try nursing more frequently and let your baby determine the length of sessions. It is a common misconception that shorter nursing sessions will alleviate soreness. Allowing your baby to latch and then unlatch of their own accord will be more effective in reducing damage to your already sore breasts. By nursing more frequently, you will also be dealing with a less frustrated baby which will make working on getting a deeper latch a more relaxed experience.
Avoid soaping your nipples in the shower as certain soaps can lead to more dehydration. Rinse your breasts with warm water, and wear breast shells to keep clothing from irritating your sore nipples. Do not disturb scabs and blisters unless directed differently by your physician or lactation consultant. If you have open wounds persisting for more than five days without improvement, visit your physician to see if an antibiotic is necessary to prevent mastitis and other infections.
If you are experiencing thrush, do not use your breast milk for healing your nipples. You can continue to breastfeed your baby but be vigilant for signs of thrush or worsening of symptoms.
You need to consult your medical provider and see the treatment options. For more information about the thrush read this blog.
Healing Remedies & Medications
The top go-to for sore, cracked nipples is lanolin ointments. These ointments are extremely effective for soothing discomfort. Make sure you are using the ointment immediately after your nursing session to both sooth any discomfort and ensure there is minimal residue left before your next nursing session. Your doctor or lactation consultant may also recommend a corticosteroid for application to the affected nipples. Do not use a corticosteroid unless prescribed by a medical professional.
Some more natural home remedies are:
1.) Breast milk: your own breast milk is hydrating and has nourishing properties. Apply some gently to your affected nipples like you would a lanolin cream.
2.) Compress: a warm moist compress directly on the nipple can speed healing.
3.) Calendula: calendula salves can be soothing for skin irritations. Check with your pediatrician or OBGYN before using to make sure it is safe for you and your baby.
4.) Apple cider vinegar: soak a cotton ball in diluted apple cider vinegar (1 tbsp vinegar per 1 cup water), wring it and gently dab the affected nipple. This cleans the nipple. After apply a thin layer of coconut oil to moisturize.
5.) Aloe vera: apply the aloe vera gel (without numbing agent) to the affected nipple.
6.) Tea bags: chamomile tea bags steeped and cooled until warm to the touch and applied directly to the affected nipple. Make sure to rinse nipples thoroughly before nursing your baby.
Breastfeeding vs. Pumping
You may be wondering if it is safe for you to breastfeed while your nipples are recovering from the damage. The answer is absolutely yes. As long as your baby is getting a deep latch and you are not experiencing any pain continuing to breastfeed will only help you heal. In fact, some sources recommend applying your own breast milk to your nipple the same way you apply lanolin cream.
If you feel uncomfortable or are in too much pain to continue breastfeeding, you can pump and give your baby breast milk in a bottle. Please keep in mind that using this option may result in some adjustment back to the breast, depending on how long you bottle feed for.
If you are going to pump, you have the option to buy a pump or to rent one. Under new ACA laws your insurance may be required to purchase a pump for you, contact them to find out with a prescription from your OBGYN. In some instances a commercial grade pump may not be able to help a mom keep a consistent supply. If that is the case, you could benefit from renting a clinical (also known as a hospital) grade breast pump. These pumps are a bit more powerful and will help fully empty your breast. This will keep your supply consistent until you can return to breastfeeding your baby.
As always, if you are unsure of the right way to proceed, contact a trained lactation consultant in your area. If you live in an area that does not have a qualified lactation consultant available, look into your local La Leche League or Breastfeeding USA chapters. Joining a breastfeeding support group is a great way to connect with other moms and learn from their experience. There are also lactation consultants who do online consultations. Please join our Facebook group to learn about other mothers’ experiences with breastfeeding and overcoming challenges and obstacles.
Huggins, K. (2010). The Nursing Mother’s Companion (6th ed.). Boston, MA: Harvard Common Press.