Breastfeeding – sore and cracked nipples

Not all women experience sore or cracked nipples; however, if you do it may really test your desire to breastfeed. At times you will feel that it is not worth it, and that breastfeeding is just not for you. It is very difficult to establish a healthy, breast feeding pattern if you are in pain, so ask for help as soon as possible.

Breastfeeding, like parenting, is not always easy – especially in the first few weeks after birth. Like all new skills, breastfeeding can take a while to learn and become really good at. If you are experiencing difficulties with breastfeeding, seek advice from your midwife or a lactation consultant.

What causes sore or cracked nipples?

Sore and cracked nipples are generally caused because:

  • your baby is not in the correct position for feeding. The baby will chew on your nipples if it doesn’t get the areola into its mouth
  • you have sensitive skin
  • your baby may be 'tongue-tied' (occurs in about 1.7 – 4.8% of newborns)
  • you may have inverted nipples (this is very rare).

What can you do about sore or cracked nipples?

If you have sore or cracked nipples seek help from your midwife or a lactation consultant. They will help you position or 'latch' your baby to the breast correctly. In most cases, once the baby is correctly positioned the nipple heals within two or three days.

If your baby does not latch on to the breast well, remove them from the breast and get them to latch on again. Take care to release the suction by gently sliding your finger between his or her mouth and the breast. Pulling them off the breast while they are enthusiastically sucking will further damage your nipple.

Other things that may help include:

  • Making sure you are sitting comfortably to feed your baby.
  • If one nipple is sorer than the other, start feeding from the less painful side so that your baby does not feed furiously on the sore breast.
  • Some women find that feeding from one breast per feed (rather than both) allows them to 'rest' the nipple for a longer duration and helps with healing. 
  • Try expressing a little milk first before breastfeeding. This will soften and lubricate the nipple. Do not use creams or drying agents on the nipples.

Relieving pain from sore or cracked nipples

  • Some women use a warm hot water bottle or wheat bag to relieve pain. Others find that they get good relief from cold packs.
  • Go without a bra if it is more comfortable.
  • Paracetamol is considered safe to take for the pain.
  • If you are reluctant to take pain relief, talk with your doctor or midwife.
  • It is very difficult to establish a healthy, breast feeding pattern if you are in pain, so ask for help as soon as possible

Tongue-tie

Approximately 1.7 – 4.8% of babies are born with what is known as 'tongue-tie'. This is when the thin membrane connecting the tongue to the base of the mouth limits movement of the tongue. This may be because it is too short or it is attached in such a way that it “ties down” the tip of the tongue. Some tongue-tied babies breastfeed well, but many struggle to make a good latch and are unable to feed as well as babies without tongue-tie.

Tongue-tie has been linked to a number of symptoms in mother and baby including:

  • reduced milk supply
  • sore nipples or a sensation of “chomping”
  • trouble latching the baby (baby may become frustrated)
  • thrush (damage caused by the poor latch is a great place for thrush to settle)
  • mastitis
  • very long or frequent feeds
  • baby making a clicking noise or spilling milk out the side of their mouth
  • baby being described as “windy” or as having “colic”
  • low weight gains or “failure to thrive”
  • reflux.

If you or your baby are experiencing any of the symptoms above, talk to your midwife or a lactation consultant. 

Tongue-tie handout Community birth services (NZ)

Inverted nipples – do inverted nipples make it hard to breastfeed?

If you are concerned that you have an inverted nipple or nipples seek advice from your doctor, midwife or lactation consultant. Don't forget that babies breast feed, not nipple feed and that it is very rare for women to not be able to feed because of an inverted nipple.

Thrush infection

Sore, itchy or cracked nipples may also mean you and your baby have thrush. It can affect your baby as a red nappy rash or white spots may appear inside your baby’s mouth. It is easily treated with medication from your midwife or doctor. You should continue breastfeeding.

Support


You can phone Plunketline on 0800 933 922 anytime day or night for advice about breastfeeding. 

You can also talk to your midwife, doctor or Plunket nurse.

For detailed help, contact a lactation consultant.

Other groups to contact include La Leche League and your local Parents Centre.

Learn more 

Breastfeeding (wide range of resources) Ministry of Health (NZ)

Online support  Breastfeeding (NZ)

Lactation consultant website and Facebook support group Kellymom (USA) 

Credits: Original material provided by everybody. Reviewed By: Health Navigator NZ Last reviewed: 01 Sep 2014