What it is
Your nipples are sore, or cracked, or bleeding, and you are dreading the next feed.
Some tenderness is normal early. The nipple is being pulled into a shape it has never been in, eight to twelve times a day. What is not normal is pain that lasts the whole feed, skin that cracks or bleeds, or a nipple that comes out flattened like a new lipstick. Those point to a shallow latch, a position that pulls, a tongue tie, or a pump flange that is the wrong size.
What's typical
Tenderness peaks around day three to six and fades by two weeks. Latch-on pain in the first 20 to 30 seconds that then eases is common in week one. Up to eight in ten mothers report some soreness. About one in three gets a crack.
Once the cause is found and changed, cracks often start to close within a few days. Blood in the milk is safe for the baby and does not need to be thrown away.
What's known
The Academy of Breastfeeding Medicine says persistent pain is a sign to look for a cause, not something to push through. A Cochrane review found no cream, including lanolin, clearly better than expressed milk or nothing for healing. Silver cups, hydrogel pads, and lanolin all have fans and little study. They are low-risk, and the latch is still the thing to change.
What helps
- Get the latch looked at this week, not next. Many hospitals and WIC offices offer free visits.
- Nose to nipple, wait for a wide open mouth, then bring the baby in chin first. More areola below the nipple than above.
- Break the suction with a finger in the corner of the mouth before taking the baby off.
- Start feeds on the less sore side. Try a different position so the pressure lands somewhere new.
- Air dry after feeds. A little expressed milk rubbed in, or a cream if you like one. Change damp pads often.
- Check your pump flange size. A flange that rubs the nipple wall causes damage on its own.
When to call someone
- Todaya crack with pus or yellow crust, a fever, a red hot breast, or pain so bad you are skipping feeds.
- Todaythe baby is not gaining, has fewer wet diapers than expected, or cannot stay latched.
- This weekpain that lasts past the first 30 seconds of a feed, or past two weeks. Book a lactation consultant.
- At your next visitnipples that are white, blue, or burning after feeds, or pain with no visible damage.
Who helps
Tools: Feeding Prep · Birthworker Directory
Related
- Getting a deep latchFeeding Your Baby
- Tongue and lip tiesFeeding Your Baby
- Flange sizingFeeding Your Baby
- Thrush and other nipple infectionsPostpartum: Your Body
- Nipple shields: when they help, how to wean offFeeding Your Baby
- Finding a lactation consultant (and what IBCLC means)Feeding Your Baby
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Sources
- Academy of Breastfeeding Medicine — Clinical protocol on persistent pain with breastfeeding
- Cochrane — Interventions for treating painful nipples among breastfeeding women
- La Leche League International — Sore nipples
- NHS — Sore or cracked nipples when breastfeeding
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