Tender and Sore Nipples

Moderate nipple tenderness is normal for many women in the first week of breastfeeding. But it should not be severe or last more than a couple of days. The most common cause of sore nipples is improper positioning or a poor latch on.

If you are experiencing sore nipples and you have double checked both positioning and latch, you may have thrush. Thrush is a yeast infection that can travel between your breast and your baby's mouth. If you or your baby took antibiotics during or after birth, you have an increased chance of thrush. Thrush can make nursing very painful, but it is usually easily treatable. You must seek treatment if you suspect thrush.

See: Thrush for more information about symptoms, treatment and relief.

Blisters, cracking, bleeding and/or pain that is persistent during or in between feedings is not normal. Check with a lactation consultant, your doctor or La Leche League if you have any of these problems.

A crack or split in your nipple can be excruciating and again is often caused by improper positioning, latch-on, or removal from the breast. For relief until they heal, try the tips below.

The use of ointments and creams for sore nipples is fairly controversial. If you do choose to try an ointment to soothe the pain, keep in mind the following information. Do not use anything that may be toxic. A product called Lanisoh is available in many stores and through the La Leche League. It is a purified Lanolin. A potential drawback to Lanolin is the possibility of an allergic reaction (your skin or your baby). Do not use a lanolin based ointment if you are sensitive to wool. Vitamin E oil is an often mentioned remedy. If you decide to use it, do so sparingly and well before nursing. Vitamin E is a fat soluble vitamin and could accumulate in your baby's liver. Safe levels for infants have not been determined. I don't recommend it. Petroleum based salves will prevent your skin from breathing while alcohol containing products will be too drying. You may be better off in the long run not using any special products on your breasts. No salve or product has been proven to aid in the healing of sore nipples.

These tips may be helpful while you fix the source of the pain:

• Alternate positions at each feeding. Rotate between various holds like the cradle, football, and laying down to find the most comfortable positions for yourself. Use pillows to bring the baby up to the height of your breast to reduce tugging and pulling on your nipple.
• Nurse more frequently. Your baby won't be as hungry and may nurse less vigorously. Offer the less sensitive breast first.
• Be sure to release the suction before taking her off the breast by inserting your finger gently into the side of her mouth between your breast and her tongue.
• You could try rubbing your nipples with ice before feeding to slightly numb them.
• Keep your nipples dry and expose them to air whenever you can. You might try drying them with low heat from a hair dryer.
• Applying a small amount of breastmilk when you are done nursing, then letting it air-dry before covering yourself up might help.
• Avoid using soap on your breasts. It can be very drying.
• Change your breast pads frequently if you are using them, to keep your nipples from soaking in the dampness.
• If your breasts are engorged, try expressing a little milk before feedings. Engorged breasts make it difficult for your baby to latch on. Expressing a little milk by hand or breast pump can help make the latch-on easier.
• Soaking your nipples in a solution of salt and water (1/4 teaspoon of salt per cup of water) for 15 minutes or so between feeding may help heal them. If you have a crack in the nipple this may be too painful.
• Try using deep breathing, soft music or other relaxation techniques during breast-feeding. I probably should have tried this when I suffered cracked nipple when my daughter was a month or so old. Instead, every time I fed her I chanted a "mantra" that went something like this: "Ouch, oh-my-God-this-hurts *expletive deleted* oh, ooh, ooooh, ouch *another expletive deleted* this hurts..." I'm not sure if it really helped or not but it did seem to help me get through the initial pain.
• If severe trauma to the nipple is present, it may be necessary to remove the baby from the breast for a couple of days while you use a pump to express milk for feedings. If the pain has gone this far you likely will have sought professional help already.