Do you get sore nipples when breastfeeding?
Discomfort or tenderness is to be expected during the early days of breastfeeding, extreme pain when nursing is not. If your nipples are damaged, cracked or bleeding this is not normal. Nipple pain will feel different from the let-down sensation or nipple sensitivity. Pain indicates a problem and you should talk to your midwife or breastfeeding support worker as soon as possible.
Knowing how to prevent or treat nipples pain will help you with your breastfeeding. The sooner you can tackle to problem the easier it will be to fix. There are a few causes for sore nipples when breastfeeding let’s check out what may be causing your pain.
Causes of Sore Nipples When Breastfeeding
The most common cause is an attachment issue causing friction on nipples between your baby’s tongue and the roof of their mouth. If possible have your midwife or breastfeeding support worker check your attachment and positioning of baby.
This is a very common yeast infection women get when breastfeeding. Thrush survive in warm, sugary environments such as your nipples and your baby’s mouth. This infection can cause cracked, painful nipples which refuse heal. Thrush is very easy to diagnose and is usually visible as a white coating on baby’s tongue which is difficult to remove. See your midwife or doctor for anti-fungal medication for both you and baby as it will mostly likely have transferred to babies mouth.
If your breast are full of milk they will become hard and painful to touch. Sometimes baby is unable to feed as the fullness flattens the nipple. Express of a little milk by hand or with a breast pump until you feel relief.
If your breasts aren’t drained of milk regularly it can cause a milk build up. This can lead to a painful bacterial infection know as mastitis. Symptoms include red, hot, tender, swollen, lumpy breasts and often a temperature and flu like symptoms. Mastitis requires immediate medical attention for antibiotics to prevent you developing sepsis or a breast abscess.
You may have had past trauma to your nipples such as and accident, infection, surgery or piercings. These can cause nerve damage which may worsen when breastfeeding. We recommend discussing any issues with your doctor or a breast specialist.
Dry skin problems such as eczema can cause the sensitive skin on your breasts to become dry and cracked. Check that any lotions, creams, soaps, washing powder or breast pad materials are not causing an irritation with your skin.
If your nipples turn white or blue after breastfeeding, Reynaud’s Phenomenon may be the cause. It’s cause by a lack of blood flow to the nipple when feeding. You’ll get some relief with mild pain killers such as paracetamol, and keeping the breast warm and minimal exposure to air. Medication is available for on-going or long term pain. Discuss with your doctor who may prescribe nifedipine or vitamin B6.
Preventing Sore Nipples When Breastfeeding
1 . Keep them dry
Your nipples can be a breeding ground for thrush which loves the sugary milk. The best way to ward off Thrush is keep your breast clean and dry. Try to wash your breasts down with plain water at least once a day. After each feed give them a good dry with a soft muslin cloth. If you are using breast pads, make sure you change them regularly or when they are soaked. You can opt for disposable or reusable, and both have their pros and cons. Check out our breast pad buying guide here.
2. Good support
A great nursing bra is essential when your breastfeeding. Your boobs will increase a few sizes when they are full of milk. The extra weight alone can cause pain in your breasts. Wired bras can also create problems by digging into your breast. This causes milk to ‘back up’ and create painful lumps. Get yourself a good quality nursing bra to ward off any of these issues. Check out our best nursing bra recommendations.
3. Good positioning
As we’ve already discussed attachment issues are the number one cause of sore nipples. Learning how to position your baby onto the breast is half the battle. Research different positions you can hold baby in to make it easier for you to feed. You may benefit from using a nursing pillow to support baby or assist them into a great feeding position. The Boppy feeding pillow is the best seller, however the Cuddle Collection pillow is a option if your on a tight budget.
4. Regular feeding
In the early days it’s important to feed your baby regularly. It’s normal for baby to want to feed 2-3hrly. When your baby is going through a growth spurt they will want to feed 1-2 hourly. This helps to prevent issues such as mastitis as your breasts are regularly emptied. If your breast are feeling full, always offer baby a feed, even if they are not looking for one. You can also hand express off a few drops to relieve the pressure. Regular feeding will also help to ‘toughen up’ your nipples until they get used to the regular friction of a feed.
5. Seek Help
If something doesn’t feel right always seek help. This goes for anything from issues with your breasts to concerns with baby. Don’t be afraid to ask your midwife or health visitor for advice. You or baby may have to be referred on to a specialist for further investigation. Other great sourced of support include breastfeeding groups or specialist feeding support workers.
Treating Sore Nipples when breastfeeding
1. Attachment and positioning
Checking your attachment and positioning is the first step, if these are not correct then baby will continue to damage your nipples with each feed. You’re not alone if the pain is so bad that you dread the your baby wanting it’s next feed.
If you prefer to self check then the NHS have produced this excellent video on how to know if you baby is properly attached.
2. Time to heal
If you need a break from putting baby directly to the breast you can learn to express your milk. Knowing how to hand express or use a breast pump will give your breast some relief and time to heal. Choosing a breast pump with an adjustable suction will improve your comfort levels whilst expressing. Make sure you use the correct size of nipple flange for your pump otherwise this can also cause pain. Medela, Ameda, Philips and Ardo pumps come with a large variety of flange sizes. Do not turn the pump up to full suction, it will not drain milk quicker, in fact the pain will probably slow your supply.
Breast pump tip: Turn the pump up to the suction which feels slightly uncomfortable and then turn it down a notch or two, this will be your suction tolerance level.
3. Create a barrier
If you still want to persist with baby on the breast, a simple barrier between your skin and babies mouth can provide relief for you. Nipple creams are the best barrier method for breastfeeding. Check out our review on the best nipple creams available on the market.
Another barrier method is a nipple shield. These look like little plastic Mexican sombreros, which you place over the nipple and breastfeed as normal. Nipple shields are a short term solution to allow time for your nipple to heal. Prolonged use may limit your milk supply, but some mums use them the whole time they breastfeed and manage fine.
In between feeds you may want to use a thermal pad. Like an ice pack they provide a cooling relief to soothe pain. Some brands can also be heated to use when your engorged or help your ‘let down’ before nursing or expressing.
5. Pain relief
Stock up on pain relief such as paracetamol and ibuprofen. It can be enough to take the edge off the pain you experience from fullness of engorgement. If you need to take medication regularly or it’s not working you need to let your midwife or health visitor know. If you feel unwell, like you have a cold or flu, seek urgent medical advice as you have probably developed an infection.
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