Sore Nipples While Breastfeeding: Prevention and Treatment Guide
Sore nipples are a common challenge for breastfeeding mothers, especially in the first few weeks. With proper care, they are usually treatable at home. Understanding the causes and knowing how to prevent and treat sore nipples will help you continue breastfeeding comfortably.
What Causes Sore Nipples?
Common Causes:
- Poor latch - Poorly attached baby doesn't take enough areola into their mouth and sucks only on the nipple, causing pain and damage
- Improper positioning - Wrong breastfeeding positions can lead to shallow latch and nipple trauma
- Nipple confusion - Using bottles and pacifiers can change the way baby sucks at the breast
- Tight clothing or bra - Friction and pressure from ill-fitting bras can irritate nipples
- Improper use of breast pumps - Wrong shield size or excessive suction can damage nipples
- Wrong use of nipple puller or inverted syringe for inverted nipple - Applying high pressure or rigorous use of inverted syringe to treat inverted nipples may damage the nipples
- Tongue-tie - Babies with tongue-tie or other oral issues may not latch properly
- Frequent washing of nipples - Over-cleaning removes natural oils that protect the skin
- Thrush or bacterial infection - Fungal or bacterial infections cause persistent nipple pain
Signs and Symptoms of Sore Nipples
- Burning or sharp pain while breastfeeding
- Redness and swelling around nipples
- Cracks, blisters, or cuts on nipples
- Bruises, scabs, or white patches on nipples
- Bleeding from nipples
How to Treat Sore Nipples
1. Continue breastfeeding with the painful breast.
Stopping breastfeeding can cause milk to collect in the breast, leading to engorgement, increased pain, possible infection, and decreased milk production.
- Soak a cotton cloth in lukewarm water and gently press it on the painful breast to ease discomfort
- Gently massage the breasts to start milk flow once the pain eases
- Latch baby to the breast once milk flow starts
- Take care to latch the baby in proper position while breastfeeding
- Start feeds with the less painful breast, then switch to the sore side once milk lets down
- Get early help from a lactation consultant if you need support latching your baby to painful nipples
Use a nipple shield. It covers the painful area of nipple while breastfeeding.
- Start by holding the shield against sore nipple with fingers and latch the baby
- Now remove your fingers – the baby's sucking will hold the shield in place
Use nipple shield under supervision of a lactation consultant – overuse may decrease your milk supply
If you cannot breastfeed at all because of severe breast pain, bleeding, or erosion of nipple, express the milk using a breast pump or hand expression every 2 hours. This will help heal your painful nipples without complications.
Learn how to express breast milk
2. Apply breast milk over your nipples.
Gently express a few drops of your milk after breastfeeding and rub it over your sore nipple. Breast milk has natural healing properties and is safe for both you and your baby. You can also apply purified lanolin cream (safe for breastfeeding), Ghee, Coconut oil, or Olive oil.
Avoid creams or lotions unless recommended by your doctor, as some may not be safe for babies.
3. Avoid frequent cleansing of nipples.
You don't need to wash your nipples before each feeding. Your nipples have natural oils that protect the skin. Over-washing removes these oils and can cause dryness and cracking.
If you need to clean your breasts, gently wash with plain water and pat dry with a soft cotton cloth. Once daily cleansing is enough.
Allow nipples to air dry after feeding when possible. This promotes healing.
Avoid soap or alcohol-based cleansers – they dry the skin and irritate your nipples. Avoid using creams, gels, or lotions over your nipples unless prescribed by your doctor.
4. Latch your baby properly.
A well-latched baby takes in the areola (the dark skin around the nipple), not just the nipple. When the baby sucks only on the nipple, it causes pain and damage.
Nipple confusion: Babies who are given bottles or pacifiers may change their sucking pattern, leading to poor latch at the breast. This is called nipple confusion and it causes sore nipples. Avoid giving bottles or pacifiers, especially in the first few weeks.
Premature and sick babies who need hospital care may also have difficulty with latching. Mothers of these babies often need support from a lactation consultant to establish breastfeeding.
Babies with tongue-tie or other mouth development issues may not suck well and need evaluation by a doctor.
Learn how to get a good latch and identify latching problems.
Consult your baby's doctor and a lactation consultant to establish proper breastfeeding. A Supplemental Nursing System (also called Lactation Aid) may be recommended to ensure adequate nutrition while babies learn to breastfeed correctly.
5. Avoid abrupt removal of the baby latched to breast.
Pulling the baby off the breast suddenly breaks the suction and can damage your nipples.
Allow the baby to finish feeding – babies will naturally release the breast when done. If you need to detach early, first break the suction by gently inserting your clean finger into the corner of your baby's mouth.
6. Correct use of breast pumps or suction devices.
If you are using a breast pump, make sure the breast shield fits properly. Use gentle and rhythmic suction that mimics a baby's natural sucking pattern.
Improperly fitted breast shields or excessive suction can damage your nipples. Electric breast pumps often work better because they provide gentle, rhythmic suction similar to a baby's sucking.
If you are using an inverted syringe for flat or inverted nipples, use gentle, pulsing suction. Apply the suction with your own hands at a comfortable level. Forceful suction can harm nipples and the surrounding skin.
Learn how to treat inverted nipples
7. Avoid tight-fitting clothes if you are breastfeeding.
Use a wire-free, well-fitted cotton bra. Your breast size usually increases during pregnancy, so your old bras may no longer fit properly. Make sure your bra provides support without being too tight.
Avoid underwire bras while breastfeeding as they can put pressure on milk ducts and nipples.
8. Keep your nipples dry.
Your nipples may leak milk during pregnancy and breastfeeding. Wear soft cotton nursing pads between your bra and nipples, and change them frequently to keep your nipples dry. Wet nipples are more prone to infection and cracking.
Allow your nipples to air dry after each feeding when possible.
When Can Nipples Get Infected?
Thrush (Fungal Infection)
If you have nipple pain and the skin around your nipple is red, shiny, and swollen, it may be a fungal infection called thrush or candidiasis.
Signs of thrush on nipples:
- Burning or shooting pain during and after feeding
- Shiny, red, or flaky skin on nipples or areola
- Intense itching
Treatment:
- Apply antifungal cream (Clotrimazole or Miconazole) as prescribed by your doctor
- Both mother and baby must be treated simultaneously to prevent reinfection
- Check your baby's mouth for white patches on the tongue or inside cheeks (oral thrush)
- Your baby's doctor will prescribe antifungal mouth gel or drops for oral thrush
- Sterilize all bottle nipples, pacifiers, and breast pump parts daily
- Wash hands frequently and change nursing pads often
Bacterial Infection
Bacterial infections of the nipple are very painful and may require immediate medical attention.
Signs of bacterial infection:
- Severe, increasing pain in nipples or breast
- Nipples and breast are red, inflamed, and swollen
- Pus or unusual discharge from nipples
- Fever or flu-like symptoms
- Warmth in the affected breast
Treatment: Consult your doctor immediately. Bacterial infections require antibiotic treatment. Continue breastfeeding if possible, as it helps prevent complications.
When To See A Doctor
Seek medical help immediately if you experience:
- Severe, worsening pain that doesn't improve after correcting latch and positioning
- Fever or flu-like symptoms (may indicate mastitis or infection)
- Pus, blood, or unusual discharge from nipples
- Deep cracks or wounds that don't heal within a few days
- Sharp, shooting pain during or after feeding (may indicate thrush)
- White, very dark, or blanched nipples (may indicate vasospasm or Raynaud's phenomenon)
- No improvement after 48 hours of proper latch and home care
- Difficulty latching despite multiple attempts and techniques
While most sore nipples heal with proper latch and home care, persistent or severe pain needs professional evaluation. Don't hesitate to contact a lactation consultant or your doctor for support.
Key Takeaways
- Sore nipples are common but treatable – most heal within 3-7 days with proper care
- The most important treatment is ensuring proper latch and positioning
- Continue breastfeeding if possible to prevent engorgement and maintain milk supply
- Use breast milk, purified lanolin, or natural oils to soothe sore nipples
- Keep nipples clean (but not over-washed) and dry between feedings
- Seek help early if pain persists or you notice signs of infection
- A lactation consultant can provide personalized support and guidance
Remember, you can successfully breastfeed even with sore nipples. Getting professional help early makes healing faster and easier. Don't suffer in silence – support is available!
Feel free to contact us for your queries and suggestions.
Find tips for getting a good breastfeeding latch
Learn More About Sore or Cracked Nipples At NHS Website
Pain reduction and treatment of sore nipples in nursing mothers