Sore Nipples

Some women experience sore nipples in the early weeks of breastfeeding. Some experts attribute early nipple soreness to hormonal changes and getting used to breastfeeding. Early pain may be considered normal as long as it passes and is not accompanied by cracks, bleeding, or other nipple trauma. It is described as tenderness during the latch-on and the first few sucks. It usually peaks in the first week after birth between days 3 and 6.

Latch, Positioning, and Suck Problems

Sucking problems are commonly caused by a problem with the position or latch and usually a baby who is correctly latched-on to the breast well will also suck properly. The soreness caused by poor latching and ineffective suckling hurts most as you latch the baby on and usually improves as the baby feeds. Mothers describe the pain as "knife-like".

Get the baby to open wide and make sure that your baby is getting as much of your areola into his mouth as possible though not necessarily the whole areola.

DO NOT let the baby latch onto the nipple.

A baby properly latched on will be covering more of the areola with his lower lip than with the upper lip.

If your nipple hurts, after baby has latched-on, try using your finger to pull down on the baby's chin to bring the lower lip out. The pain will usually subside. Do not take the baby on and off to get the perfect latch.

If you take your on and off your breast and it hurts, you will have much more more pain and damage.

Correct the latch when putting him to the other breast, or at the next feeding.

Anatomy of the baby's mouth can attribute to soreness for example babies with unusual shapped palates or short frenulums - "tongue-tied". After a feed nipple may appear flattened and develop a crack.

Any Stage

Cracked Nipple

Thrush (Candida albicans)

Fungal or yeast infection may cause sore nipples.

Treatment of sore nipples caused by thrush.

Common signs and symptoms are itchy or burning nipples that appear pink or red, shiny, flaky, and may or may not have a rash with tiny blisters, cracked nipples, shooting pains in the breast during or after feedings, and/or nipple pain that doesn't improve with better positioning or correcting th baby's latch.

There are not always visual symptoms though it is sometimes accompanied by thrush in the baby's mouth that looks like white milk curd patches.

The pain from the fungal infection goes on throughout the feed and may continue even after the feed is over. The pain of the fungal infection is often described as deep breast pain that is intense and knife-like and burning and radiating, however not all women experience burning.

A new onset of nipple pain when feedings had previously been painless is a tip off that the pain may be due to a yeast infection, but the pain may be superimposed on pain due to other causes. Cracks may be due to a yeast infection.

A yeast infection may be a sign of another existing condition such as:

Immunosuppression

Use of Irritating Substances

Chapped and sore nipples can be caused by using irritating substances. Substances that may cause sore nipples:

soap Regular bathing or showering is enough to keep nipples clean and you do not need to use soap.

alcohol Products containing alcohol may cause dryness and be irritating to nipples.

lotions and ointments The use of some products have been found to cause contact dermatitis and hives in some women.

Dermatologic

Skin conditions such as eczema, dermititis, psoriasis, and poison ivy may also cause late onset nipple pain.

Eczema

A home remedy for mild nipple eczema is to immediately rinse nipples after feeding with a solution of bicarbonate soda dissolved in a pint of water.

Eczema on only one nipple that doesn’t respond to treatment may be an indication of a rare form of breast cancer, Paget’s Disease and should be brought to the attention of your doctor.

Compression Vasospasm and Raynaud's phenomenon

The pain associated with blanching of the nipple is frequently described by mothers as burning, but generally begins only after the feeding is over. It usually lasts for a few minutes before the nipple returns to its usual color and often the nipple pain develops into what mothers describe as throbbing.

This is caused by the blood vessels constricting and then relaxing. This type of pain may continue only after the feed and not during it.

It is most important to correct positioning and latch. In many cases, the problem of nipple soreness ends there.

Applying heat right after nursing may prevent or decrease the pain. Use a warm washcloth or water bottle.

Other Reasons for Sore Nipples

Wearing a bra that is too tight

Teething

Improper use of breast pump

Hormonal changes due to pregnancy

For some breastfeeding moms, sore nipples are a reason to wean. Mothers who choose to continue breastfeeding regardless of their discomfort learn to cope with the tenderness in various ways. Some of the suggestions pregnant, nursing moms have made are:

Talk to your nursing baby or toddler. Explain and ask them to be gentle or to nurse for shorter periods. Reassure them that they are not to blame for your discomfort.

Try nursing in different positions.

Use relaxation and breathing techniques.

Make your milk flow with hand expression before your baby or toddler latches on.

Sore Nipples ~ Troubleshooting Chart

Nipples Shields

Last Resort

During this time, it is helpful if your baby is not fed with an artificial nipple . It is best for you and your baby if the baby is fed expressed milk.

This is a last resort and taking a baby off the breast should not be taken lightly and, it often doesn’t work.