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Sore / Cracked Nipples are a common cause for painful breastfeeding

Updated: Nov 12, 2019

New mothers may experience nipple pain in the early days of breastfeeding. A large percentage of new moms can experience some form of nipple soreness. It is a very common condition that is temporary, usually going away after a few days. Unless there are underlying causes that need to be corrected, many mothers find nipple soreness peaks on the fifth to seventh day of breastfeeding and then usually gets resolved over the next few days.


There may be quite a few causes of sore nipples, including:


  • Improper or incomplete latch

1} Slippage during feeding

2} Baby is tongue-tied (restricted or shortened frenulum)

3} Having inverted or flat nipples

  • Body positioning during breastfeeding

  • Stopping a breastfeeding session without first breaking the suction

  • Wearing bras that are too tight on the nipples

  • Sensitive Skin


Your breast milk can also help your nipples heal by providing an antibacterial protection. If you have a crack in your nipple or broken skin, you can squeeze out a few drops of breast milk and gently rub over your nipple. Let your nipples air dry before covering with your bra or nursing pads.

If your nipple that pain persists for more than 7 days, goes away and then returns, or your nipples are actively bleeding, Nipple pain that persists beyond this period should not be considered normal and warrants further investigation. If left untreated, sore nipples can lead to other breast problems such as engorgement, mastitis or early cessation of breastfeeding. Nipple pain or sore nipples may occur with or without infection.


Evaluation of nipple pain


You need to see a lactation consultant or healthcare provider for proper evaluation of the underlying causes. Consultation with a Lactation professional is recommended. A feeding history, examination of the mum's breast and nipples and the baby's mouth, along with observation of a breastfeed, is recommended.

Addressing the underlying causes will resolve the soreness and allow the nipples to heal and the mother can then feed the baby with pain free breastfeeding sessions.


Preventing sore nipples


The key to curbing nipple pain is a good latch. That means the nipple and a large mouthful of the breast needs to be pulled deeply into the baby’s mouth. If you’re not sure if you’re achieving this, work with a Lactation Consultant who can help you and your baby find the right positioning.

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Watch for hunger cues and breastfeed often. This will prevent vigorous nursing that may irritate your breasts more. You can also hand express or pump some breast milk before putting baby to the breast so that the milk is flowing faster and baby doesn’t nurse as hard at the beginning of the breastfeeding session.

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When you’re finished nursing, gently break the suction by putting your finger between baby’s gums and holding it there as you are removing him from your breast to prevent pulling on your nipple.




References

Amir, L.H. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med 9, 239-243 (2014).

Jacobs, A. et al. S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period: AWMF Guidelines, Registry No. 015/071 (short version) AWMF Leitlinien-Register Nr. 015/071 (Kurzfassung). Geburtshilfe Frauenheilkd. 73, 1202-1208 (2013).

American Academy of Pediatrics and The American College of Obstetricians and Gynecologists. Breastfeeding handbook for physicians 2006).

Lawrence, R.A. & Lawrence, R.M. Breastfeeding: a guide for the medical profession (Elsevier Mosby, Maryland Heights, MO, 2011).

McClellan, H.L. et al. Infants of mothers with persistent nipple pain exert strong sucking vacuums. Paediatica 97, 1205-1209 (2008).

McClellan, H.L. et al. Breastfeeding frequency, milk volume, and duration in mother-infant dyads with persistent nipple pain. Breastfeed Med 7, 275-281 (2012).

McClellan, H.L. et al. Nipple pain during breastfeeding with or without visible trauma. J Hum Lact 28, 511-521 (2012).

Hale, T.W.,& Rowe H.E.,. Medications and mothers' Milk 2014 (Hale Publishing, Plano, 2014).

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