Breastfeeding A to Z

Nipple Soreness

Information listed by baby’s age

DELIVERY

Nipple soreness is not unusual in the first week after delivery. If the tenderness lasts longer than a week and is felt throughout the entire feeding then you need to have someone who is knowledgeable about breastfeeding watch you feed your baby.(1)  An experienced nurse or lactation consultant can be especially helpful in this situation. If needed, these early days are the best time to correct your baby’s latch-on, so you can feed your baby without discomfort. As with engorgement, preventing nipple soreness is the first thing to try.

If your baby latches on and you have discomfort, but the discomfort gets better as the feeding goes along, your baby is usually latching on properly. If you have any doubts about how your baby is feeding, again, have someone knowledgeable about breastfeeding watch you feed your baby. You want to correct any problems with latching on as soon as possible.

For comfort:

  • Breast milk can be applied to the nipples after feedings. (1)
  • Air drying, keeping bra flaps down or nipples exposed to air.
  • Using breast shells (plastic domes that prevent anything from rubbing on the nipple). They can be purchased at drug stores, or medical supply.  If any milk leaks into these–discard it. (2)
  • Lansinoh ® a purified form of lanolin can be used to help the nipple heal between feedings. It can be applied after a feeding and does not have to be wiped off before the next feeding.(1)(2)
  • Gel-packs made of hydrogel or glycerin pads can be used between feedings to promote healing and prevent clothing from rubbing the area. They can be purchased at your local drug store/pharmacy. Check with your healthcare provider if you have questions about their use.(1)(2)
 References:
  1. Mohrbacher, N, Stock, J, La Leche League International The Breastfeeding Answer Book, 3rd Revised edition, Schaumburg, IL, La Leche League International, Jan 2003, pp 456-57, 466-67, 492, 494-98.
  2. Mannel, R, Marten, PJ, Walker, M, Core Curriculum for Lactation Consultant Practice, 3rd edition, Burlington, MA, Jones & Bartlett Learning, 2013 pp 647, 650-52.

 

WEEK 1

It is not unusual in the first couple of weeks after having a baby to experience nipple soreness when the baby latches on to the breast.  If nipples are sore to begin a feeding, but the soreness gets better as the feeding goes along, the baby is probably latched on correctly.  If this is happening to you, the nipple soreness will get better each day.

Some of the discomfort is because as the baby latches onto the breast it takes a little time for the sucking of the baby to tell your body to let the milk flow from the breast. (your let-down reflex)  In the early days this may take a couple of minutes.  During this wait, between baby starting to suck and let-down of milk, there is a vacuum created and this is what makes you want to clench your teeth and curl your toes.(1)  As your body gets conditioned to having a let down, the let down will happen more quickly, to the point of happening almost immediately when the baby starts to suck.  As the let-down reflex becomes more efficient the discomfort you may feel with it will diminish too.

Getting used to a baby sucking at the breast takes some time, but you can speed the learning process.  The most important way to avoid discomfort is to make sure each time baby latches on to the breast that they have their mouth open wide before you latch them on.  If you have seen them cry or yawn, you know they can do this.  For further information about nipple soreness, see Delivery section above.

References:

  1. Mannel, R, Marten, PJ, Walker, M, Core Curriculum for Lactation Consultant Practice, 3rd edition, Burlington, MA, Jones & Bartlett Learning, 2013, p 309.

 

WEEK 2

Hopefully, nipple soreness is decreasing by your baby’s second week of life.  If you still have breaks in the skin that are not improving you need to have someone watch you nurse your baby and evaluate what is going on.    See Where to Find Breastfeeding Help

You could still be experiencing some tenderness as you start each feeding, but within a minute or so the soreness should decrease.  You are still aware of the tugging or pulling sensation of the babies suck, but it is comfortable.

If you still have breaks in the skin, but they are healing, pay attention to proper latching on.  If desired use breast milk or anhydrous lanolin on the nipple after a feeding to help healing.  Remember the lanolin does not need to be wiped off before the next feeding.  Anything else you put on the breast please check with your healthcare provider.

Sometimes continued nipple soreness can be thrush.  Thrush or candida albicans, will not resolve with the usual measures for nipple soreness.  If you have nipple soreness that is just not going away, check Care Plan for Thrush and see with your healthcare provider.

WEEK 3

You may still have some discomfort as the baby latches on, but it should go away within the first minute or so of feeding.  You will notice swallowing begins pretty quickly once a feeding starts.  Your let down response is quicker now than in the first week.  If you still have areas of skin that are healing continue to use breast milk or anhydrous lanolin on them after every feeding.  This helps promote healing.

If you are having soreness and you had gone a period of time without it, check that you are latching the baby on correctly, not developing the habit of the baby working their way on to the breast, but opening wide and taking in as much of the nipple and areola (dark area around the nipple) as is possible at the start of each feeding.  If you are having pain after a feeding or if the breast feels like it is on “fire”, you may have thrush (a yeast infection).  You need to see or talk to your doctor as soon as possible.  See Care Plan for Thrush for further information.

WEEK 5-6

Usually by five to six weeks from delivery the nipple is handling its feeding job without pain.  If you are still having discomfort or have been going along with no problem and then suddenly you have pain again, please seek out someone to watch your baby nurse.  Be sure you are paying attention to how your baby latches on, sometimes we start to be lax about latch on and just one time of nursing without a good latch, can create a sore spot.

Make sure baby opens wide, draws the nipple into the mouth, their lips are flanged out and you can see jaw, ear and temple movement as they suck.  If you are concerned about nipple soreness, contact your healthcare provider and/or a lactation consultant.  You can refer back to Where to Find Breastfeeding Help.  Sometimes a sudden onset of nipple soreness can be due to thrush (a yeast infection).  See Care Plan for Thrush.

 

2 MONTHS & BEYOND

By two months of age and beyond, nipple soreness should be gone.  If you still have breaks in the skin, make sure they are healing.  If things are getting worse and not better, with nipple soreness, have your doctor check for thrush (yeast infection) on the nipples.  Especially, if you have been pain free for a period of time and then all of a sudden you have nipple soreness again.  You can refer back to Care Plan for Thrush for more information.