Breast-feeding should be comfortable and enjoyable. Unfortunately, sore nipples are a common problem for breast-feeding mothers. Often mothers quit nursing their babies early because of sore nipples, but this doesn't have to happen. Sore nipples usually can be prevented or treated.
Mild nipple soreness at the start of feedings during the first few days of breast-feeding usually needs no treatment. However, nipple pain that is severe or lasts for a week or more is not normal and should be checked by your healthcare provider or a lactation consultant.
The most common cause of severe nipple soreness is the position of your baby's mouth on your breast. The size and shape of your nipples and your baby's mouth can affect how your baby latches on the breast. Also, your infant's sucking habits can cause nipple pain.
Other possible causes of nipple pain are
If your baby is not latching on to your breast correctly, he may not be getting enough milk. Also, nipple pain may cause you to put off nursings or not let the baby suck long enough when he nurses. Sucking is important because this is what triggers your milk to flow (called the let-down reflex). Nipple pain can cause a drop in your milk supply. As a result, your baby may not gain weight well. Sore nipples and low milk supply problems often go hand-in-hand.
The following guidelines should help your nipples feel better within a day or so.
First, support your breast. With one hand, put 4 fingers below your breast and your thumb on top (C-hold). Or you can support your breast by rotating your hand into a U-hold, with your fingers and thumb on either side of your breast. Your fingers should be on the outside of the areola (the darkened area around the nipple) so that they won't touch your baby's mouth when he attaches.
Your baby should get a good, deep latch. Use the football hold or cross-cradle hold so that you have more control of baby's head. With your hand, hold the back of the baby's head, his neck, and upper back and shoulders. Your fingers will be behind his ears. Lightly stroke your baby's upper lip with your nipple until he opens wide (like a yawn). Quickly move the baby onto your breast, so that his chin and lower jaw touch the breast first. His head is tilted back slightly as he comes onto the breast. This results in an off-center latch, with his upper lip closer to the top of the nipple, and the lower lip further from the bottom of the nipple. The baby will be able to get milk more easily and cause you less pain.
Babies suck harder at the beginning of feedings. After your baby has nursed briefly and milk flow has begun, move her to the second breast with the sore nipple. This should make nursing more comfortable because the baby will suck less vigorously once milk starts to flow. As soon as possible, once the nipple soreness is gone, alternate the breast you start each feeding with to prevent a lopsided milk supply.
If you wear breast pads, change them as soon as they get wet. Gently pat your nipples dry with a clean cloth after nursing. Wash your nipples with water (no soap) when you bathe. Air dry your breasts. Don't dry your nipples too much. Too much dryness can irritate the skin.
At the end of each feeding, put a thin coating of USP Modified Lanolin (medical grade) on your nipples. This will keep the skin from getting too dry. This purified lanolin product can be bought from most places that rent breast-pumps.
USP Modified Lanolin (medical grade) is best. Put a fresh coating on your nipples after each feeding. Also, wearing wide-based breast shells over your nipples between nursings can reduce the discomfort and speed up healing by preventing direct contact with your bra. Hydro-gel pads may be worn on nipples to provide soothing, cooling relief.
You can stop nursing and pump milk for 2 to 3 days while your nipples heal. You can rent a hospital-grade electric pump for a short time to express your milk comfortably. Pumping is a good way to empty your breasts and maintain or increase your milk supply while your nipples heal. Other types of breast pumps generally are not as comfortable or effective as a rental hospital-grade electric pump.
To find where you can rent a pump, call Ameda at 1-866-992-6332 or Medela at 1-800-435-8316.
A cracked nipple may increase your risk for a breast infection (mastitis). Check your nipples for any signs of infection. The signs are described below.
Call your immediately if:
Call your healthcare provider or lactation consultant during office hours if:
In this case, you may need to take pain medicine.
Call your baby's doctor during office hours if:
Your baby may not be satisfied because your milk supply is low or because your baby is not emptying your breasts. After weighing your baby, the doctor can decide whether you need to change your feeding schedule or offer your baby extra breast milk or formula. You may need to use an electric pump for a short time to pump out any milk left after nursings. Pumping will help increase your milk supply.