Tips from an LC: I Have Sore Nipples from Breastfeeding, What Should I Do?

Transcript: I Have Sore Nipples from Breastfeeding, What Should I Do?

One of the leading causes for moms to stop breastfeeding in the first few days and weeks after birth is sore nipples and/ or nipple damage, with the research showing between 16 - 79% of moms experience this in the first week.

There are two types of nipple pain, one which is pretty typical nipple pain, and doesn’t usually indicate that there is problem with how you are feeding your baby - And then the type of pain that usually indicates that more specialist breastfeeding support is needed, as soon as possible.

Here's How to Know the Difference Between Pains:

I will now give you some examples of general normal nipple pain that happens during the first 1 to 2 weeks of breastfeeding your baby:

• When you attach your baby to the breast, there may be some pain at first but it shouldn’t last more than about 30 seconds into the feed. This pain is usually described as mild pain or discomfort but of course pain is subjective and every woman experiences it differently. The main thing is the pain should not continue throughout your entire breastfeed and there definitely should be no pain in between feeds.

• This first type of nipple soreness tends to peak around days 3 to 5 and should start getting better from day 7, with no further pain after two weeks.

• You should not see any skin damage on your nipple. That means no cracks, blisters, or bleeding.

• ...And your nipple should not look flattened, creased or pinched (i.e not like the shape of a new lipstick!)

Nipple pain that indicates there is likely a problem and it is important for you to seek help from a breastfeeding specialist is:

• Pain that is described as intense or excruciating

• Pain that continues throughout the entire feeding

• Pain when you’re not breastfeeding

• Pain that continues past the first couple of weeks

• Damage to the nipple, such as cracks, blisters, or bleeding

So, Why Do Sore Nipples from Breastfeeding Occur?

The most common reason that soreness or damage occurs to the nipple is how a baby latches on at the breast. If your baby doesn’t take in enough of the nipple and breast into their mouth, your nipple may rub on the front part of their mouth - known as the hard palate. This can be painful for you because it causes misshaping and pinching of your nipple, but it can also mean that your baby is not be able to get enough milk to flow out of your breast.

This, understandably, can lead to a very difficult situation, where a baby is unable to drink enough milk to satisfy them, so they are hungry more frequently - But your nipples feel so sore that the thought of more frequent feeds can be quite distressing. This is why it’s important to seek support as quickly as possible from someone who is well-skilled in breastfeeding and lactation support. There are some other reasons why moms might experience sore nipples:

• Engorgement
• Tongue tie
• Flat or inverted nipples
• Thrush
• Mastitis
• Vasospasm

Your healthcare provider will advise you on these further.

What Can You Do to Help Heal Your Nipples and Stop the Pain?

Seek support! The sooner you get someone to look at you and your baby feeding, the sooner they can offer some advice which can hopefully lead to more confident and pain-free breastfeeding. Try not to leave it until the last minute to get support. Breastfeeding support can be found both online or in person, depending on where you live. You can Google “lactation consultant in my area” or “breastfeeding support in my area” to get a list of help close by.

You might want to try different feeding positions. There are several positions to feed a baby in, and not every position will feel comfortable for you or your baby. So, trying out a few different breastfeeding holds is a good idea to help you and your baby feel relaxed and happy. Also, holding your baby in a different position can oftentimes help with improving and deepening their latch at the breast. Here are just some of the positions you might like to try:

• Laid back breastfeeding, or also known as biological nurturing
• Football hold
• Koala hold
• Cradle hold

You will also want to check that your baby is not just “nipple” feeding. Babies need to take in not only the nipple, but some of the underneath part of the areola (the brown or pink skin around your nipple).

You can express some of your breast milk onto the nipple and rub it in gently after feeds and use some lanolin cream like Purelan on the nipple after feeds as well.

You may want to protect your nipples from contact or rubbing with clothing. Breasts shells can be helpful, as they form a barrier between your nipple and your bra while your nipple is healing.

You may be advised by your healthcare professional to rest your nipples, to allow them to heal. If this is the case, it is advised that you maintain your milk supply by pumping. Mimicking the minimum number of feeding sessions that a healthy full-term baby would be having is important to ensure you keep making enough milk. The magic number of pumping sessions is 8 per 24 hours! If you have access to a double-electric pump, pumping both breasts at the same time will help you pump in half the time. Double pumping also leads to an extra letdown, enabling up to 18% more milk to be expressed.

You may also be advised by your healthcare professional to use a nipple shield, as this may help protect cracked nipples during breastfeeding and may enable breastfeeding when latching on is difficult, painful, or if you have flat or inverted nipples. If you are using a nipple shield or expressing and resting your breasts while your nipples are healing, make sure that you keep in regular contact with your breastfeeding or lactation specialist. It is important that you have ongoing support and help to get your baby back on the breast as soon as your nipples are feeling better and you are feeling ready.