Sore nipples during breastfeeding what to do?

Midwife Aliza Carr from Bumpnbub explores what can be done about sore nipples after breastfeeding.
Sore nipples during breastfeeding what to do?
2021 - 07 - 12

Breastfeeding is a learnt skill. Like with learning any new skill, it can take some time to get the hang of it. Breastfeeding can feel awkward, complicated and painful for some mothers. You can expect discomfort and tenderness in the first few days of breastfeeding, but it’s not normal to feel pain. Your nipples may be generally sore, or you may have physical damage that is causing pain. Nipple damage can be common in the early days with a newborn, especially with your first baby, due to cluster feeding, or it may be bubs latch. Some mothers find their nipples can crack, bleed or blister. A crack on the nipple can be very fine and hard to see. Breastfeeding with a cracked nipple is often painful, and breastfeeding may cause it to bleed.

Working out the cause of your sore nipples is essential, as this helps to find the right solution. Once you have determined the solution, your sore nipples will improve, and the pain won’t usually last long.

What causes sore nipples?

  • Incorrect attachment and positioning are the most common cause of sore or cracked nipples. Your newborn should have a large portion of the areola in their mouth whilst feeding, with your nipple against the roof of their mouth, underneath their tongue. Check your nipples at the end of each feed for signs of damage. If they look squashed or you see cracks, that may indicate that bub isn’t latching correctly.

sore nipples

  • A tongue-tie or a structural difference with the shape of your baby’s mouth may affect their ability to breastfeed. If the soreness doesn’t get better each day, consult an experienced lactation consultant or paediatrician to examine your baby’s mouth.
  • Infection on your nipples can cause sore nipples and shooting pain in the breast. Infection can be bacterial, thrush or both, and can be passed back and forth between Mama and bub. If you have a nipple infection, both you and your baby will need treatment. It is best to consult your GP to determine if an infection is present.
  • Cluster feeding bub feeding frequently (or what feels like continuously) can also play a part in sore nipples. After each feed, apply Lovekins Nipple balm to help soothe tender skin. This incredible nipple balm is loaded with goodness - each ingredient was carefully selected with sensitive nipples in mind. This nipple balm contains only natural ingredients such as Kakadu Plum, which is the highest source of vitamin C on the planet, to help promote the healing of damaged skin. Shea and Jojoba butter are also essential ingredients which can reduce skin irritation and soothe the skin.

What can you do for sore nipples?

Be patient, even though it can be challenging. Soreness typically settles down after a few days as your body gets used to breastfeeding and your baby’s sucking becomes more efficient. Education and knowledge on the potential reasons for nipple soreness, such as those above, can assist you to know how to heal your nipples.

sore nipples Image source:

Support: Please consult an appropriate healthcare professional if you are experiencing nipple pain or damage. Lactation Consultation (LC) can provide support with nipple damage, managing pain difficulties when feeding and assess tongue function and mouth structure of bub. An LC can also suggest using a nipple shield if appropriate, which may help with sore nipples in the short term. GP or paediatrician can provide support and assess bub’s mouth to see any structural abnormalities such as a tongue tie. Midwife, ABA counsellor (hotline or via website), child health nurse or local hospital breastfeeding service are other avenues for support.

Attach bub when showing early hunger cues: Offer a breastfeed before your baby is crying with hunger. A calmer baby will be gentler on your nipples. Also, a great tip from the ABA is to start the feed on the less sore breast.

Baby-led attachment: Letting bub self-attach by moving across your breast and using their hands to find the nipple and position themselves. Once a baby is attached deeply, you will most likely find breastfeeding is less painful. If feeding is painful, you can un-attach bub from the breast by inserting your little finger into the corner of their mouth and gently remove your baby from the breast.

Different breastfeeding positions: such as laying-back, cross-cradle, football hold or lying-down, may take the pressure off the painful areas of your breast. Sometimes breastfeeding is sore because mama has been advised to position bub in a way that feels uncomfortable. Uncomfortable breastfeeding positions can cause your baby to squash the nipple as they feed, which can be painful. Get support from an LC with positioning if you feel this may be the issue. A little time is usually required to solve nipple pain once positioning is comfortable for you and your baby.

Trigger let down before your baby attaches to the breast. Damaged nipples hurt the most before your milk lets down, and then pain usually eases. To trigger your let-down, try looking at or thinking about your baby and taking slow deep breaths. Then, massage your breasts gently, apply warmth to help get your milk flowing, and express some milk to lubricate the nipple.

sore nipples

Express breastmilk if nipple damage is severe (cracked or bleeding nipples), or you cannot tolerate bub breastfeeding. Pumping is an excellent alternative to breastfeeding, and bub is still able to consume your nutrient-rich breastmilk while your nipples have time to rest and heal. The best way to express breastmilk is with a breast pump on a low gentle setting, or hand express if you don’t have a pump. Feed bub your breastmilk via cup or bottle until your nipple/s are healed and not painful. You may need to allow 12–24 hours to rest the nipple and let healing begin.

Use nipple cream and breastmilk: Applying Lovekins Nipple Balm between feeds can accelerate the healing process, as the balm is packed full of nourishing and healing ingredients. Using an all-natural product that is safe for babies is essential. There’s no need to wipe it off, just let it soak into your nipples and areola in between feeds. Lovekins Nipple Balm is endorsed by the Australian College of Midwives so you can rest assured knowing that you are using the safest and best product for yourself and your baby.

You can also hand-express a few drops of breastmilk at the end of a feed, or when you have finished pumping and spread it over your nipple and areola, leaving it to air dry. Hydrogel pads can also provide instant pain relief while creating ideal conditions for healing.

Air-drying your nipples after breastfeeding and changing disposable or reusable breast pads regularly will keep your nipples dry, clean and minimize infection.

We hope these tips help if you are experiencing any pain whilst breastfeeding. Remember, you are doing a fantastic job!

Written by midwife Aliza Carr from Bumpnbub.

*All advice is general only and does not replace the need for medical advice or assistance.*

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