Breastfeeding is a natural process for you and your baby. A healthy full-term baby instinctively knows what to do when presented with your breast. You may experience nipple pain in the early days of breastfeeding. As many as 90% of new moms have some nipple soreness. It is a very common condition that is temporary, usually going away after a few days. Most mothers find nipple soreness peaks on the fifth day of breastfeeding and then resolves.
Luckily, there are some strategies to ease the hurt and help your nipples heal quickly! Below we will discuss some reasons for nipple pain and some strategies to overcome it.
Should I Continue Breastfeeding?
It is very important to continue to breastfeed if you are experiencing nipple pain. Try to nurse your baby on the least painful nipple first; she will not suck as hard on the second, more painful nipple. If putting your baby to breast hurts too much, use a breast pump or hand-express to keep your milk supply flowing.
Your breast milk can also help your nipples heal with antibacterial protection. If you have a crack in your nipple or broken skin, squeeze out a few drops and gently rub over your nipple. Let your nipples air dry before covering with your bra or nursing pad.
What Causes Sore Nipples During Breastfeeding?
There may be quite a few causes of sore nipples, including:
- Improper or incomplete latch
- Slippage during feeding
- Baby is tongue-tied (restricted or shortened frenulum)
- Having inverted or flat nipples
- Feeding too late (early vs. late feeding cues)
- Body positioning during breastfeeding
- Stopping a breastfeeding session without first breaking the suction
- Wearing bras that are too tight on the nipples
- Improper or incomplete latch
Nipple Pain Remedies & Preventative Measures
If your nipple pain persists for more than 7 days, goes away and then returns, or your nipples are actively bleeding, see your lactation consultant or healthcare provider for evaluation.
Research shows warm, moist heat is soothing for sore nipples and can help your skin heal faster. To use moist heat, run a clean washcloth or cloth diaper under warm (not hot) water, squeeze out the extra water and place it directly over your nipple. When it cools to room temperature, repeat the process. Many mothers find this method is also helpful in relieving the discomfort of engorgement, which can occur along with nipple soreness.
Another natural avenue to help nipple pain and healing is to hand express a small amount of milk and gently rub or pat it into your nipple. Be sure to let this air dry before putting your nursing bra back on.
Reverse pressure softening can be a helpful remedy or preventative measure if there is a great deal of swelling in the breast (there could be excessive swelling from IV fluids during birth or breast engorgement that makes it hard for the baby to reach or latch onto the nipple). Using gentle pressure from one or two fingers around the nipple base can move some of this swelling away from the nipple.
Proper Latching (Preventative)
Nipple pain may come if your baby does not hold a tight or proper latch. If you bring your baby to the breast when he/she is crying and is “desperate” for milk, the baby may not have/take the time to create a proper latch and this can cause problems for mom’s nipples and baby’s drinking.
To prevent this, look for early hunger cues (vs. late cues like crying) such as the baby opening his mouth, sucking on his fingers or hands, and/or moving his head in a side-to-side motion.
A proper latch starts with the baby’s mouth open wide (like a yawn), with his tongue cupped and forward. If you think your baby has latched incorrectly, don’t be afraid to break the suction gently (placing a finger in the side of baby’s mouth) and reposition.
Here are the most common breastfeeding positions. If you are experiencing pain, consider trying another position to see if this allows you & your baby to create a better latching environment.
- Laid Back/Lying Down: (bed, couch, chair) Lie down. Position your baby’s front against your front so that your body lengths are parallel, with his cheek resting on one breast. Support the baby’s bottom and/or feet while feeding.
- Cradle: (chair) Lean slightly back, don’t hunch over. Whichever breast you choose to feed on, that forearm will support your baby. Position your baby’s front toward your front and have him rest on your arm, perpendicular to your body length.
- Cross Cradle: (chair) This is very similar to the cradle position, but uses a pillow on your lap to support the baby instead of your arm/forearm, with your hand supporting baby’s head.
- Football/Clutch: (chair) Also very similar to the cradle position, but for this one, the baby should be under your arm (the same side as the breast you feed on). Pillows should support the baby’s weight.
La Leche League provides more complete information on breastfeeding positions.
Creams and Products
While most creams and ointments don’t make your nipples heal faster, they do create a soothing barrier for your tender nipples. Avoid ointments containing lanolin as they can cause allergic reactions and have a strong smell and flavor which can cause your baby to refuse to breastfeed. Newer ointments are olive oil-based and have little smell or taste to interfere with your baby’s senses.
You may also want to find a nipple cream which includes Self Heal and/or Calendula to help heal in addition to soothe sore nipples.
Hydrogel pads are another product that creates a soothing barrier for sore nipples. These thin sheets of silicone-like material are about the size of your areola and can provide relief from material (nursing pads, bra cup) rubbing against your nipple.
If nipple pain worsens after the early days of breastfeeding your nipple pain may be due to other causes like thrush, bacterial infection, or tongue-tie. Consult your healthcare professional for help.
Compiled using information from the following sources:
1. La Leche League International. Breastfeeding with Sore Nipples.
2. McClennan, HL, et al. (2012).Nipple Pain during Breastfeeding with or without Visible Trauma
Journal of Human Lactation, November 2012; vol. 28, 4: pp. 511-521., first published on June 11, 2012.
3. Cable, B., Stewart, M., Davis, J., (1997) Nipple Wound Care: A New Approach to an Old Problem.