Breastfeeding Tips For Managing Sore Nipples

November 30, 2020 Stacey Stewart

You might assume sore nipples are an inevitable part of the breastfeeding experience.

You also might have heard that your nipples are supposed to “toughen up” a bit after your baby starts breastfeeding.

You may even think that it’s normal for you to experience cracked and bleeding nipples at first.

None of that is true!

The truth is, experiencing sore nipples while breastfeeding is not normal, and it’s not something you should have to endure to make breastfeeding work.

Here’s some of the best tips to managing sore nipples.

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When you first start breastfeeding, you and your baby are both learning and trying to figure things out.

As you learn and change positions to see which breastfeeding holds are most comfortable for you, and adjust your little one’s latch — it’s normal for there to be some soreness or a “pulling sensation.”

But this should only last for 20-30 seconds, not for the duration of the feed. And it should improve as you and your baby learn the ropes of breastfeeding.

Nipples that remain sore for the entire time you’re feeding, nipples that look pinched, flattened or elongated (“like a tube of lipstick” is how some describe it) is not normal.

Toe curling pain, or pain that makes you wince—that’s not normal either. And it’s not normal for you to have cracked, cut, or bleeding nipples either.

BUT, the good news is that there are many ways to address sore nipples, and almost always there’s a solution out there to fit your issue.

If your nipples are sore, these are an absolute lifesaver. They’re super cheap, can be worn for multiple days (perfect when you’re trying to get a good latch), and are soooo soothing.

What Causes Sore Nipples?

You can’t come up with a solution for sore nipples until you can identify the problem.

Just putting nipple cream on your nipples isn’t going to do much if the way your baby is sucking continues to cause pain, for example.

So let’s look at the most common causes of sore nipples. (Sometimes sore nipples can have more than one cause.)

Poor Latching

The most common cause of sore nipples is a poor latch.

When babies latch on deeply and form a good seal around the areola, it’s much less likely that they will cause you pain.

A well-latched baby will not only suck only on the end of your nipple — they will also take a good portion of the nipple and areola into their mouth.

You want to look for a wide gape in your baby, and that their lips are flanged out, like a fish.

Your baby should also have a good seal around the breast, and not be slipping off frequently.

Poor Positioning

Positioning is just as important as latching.

Your baby uses their whole body to breastfeed!

Your baby should be belly to belly with you and drawn in close.

Position your baby a little bit below the breast so that their chin rests on the bottom of your breast and so they can tilt their head back a little while latching on.

Tongue Tie

Another common cause of nipple soreness is tongue tie.

When your baby has a tongue tie, they will usually also have decreased tongue mobility, making it harder to use their tongue to cup the breast and suckle correctly.

Often, with tongue tie, it will feel like your baby is chomping on your breast and you will feel your baby’s gums on your nipple rather than their tongue. Your nipple may look creased or pinched after you unlatch.

Damaged Nipple Skin

After your baby latches on poorly repeatedly, you may experience cuts and abrasions in your nipple. The damaged skin can then become inflamed or even infected.

Bacterial or fungal infections can take over. Sometimes the damaged skin will persist even after you have corrected the initial problem, such as a poor latch or tongue tie.

Incorrectly Sized Breast Pump Flanges

If your breasts are sore during or after pumping, and if your breasts look pinched or reddened after pumping, you’re likely using too small a breast pump flange.

You can contact your breast pump company for troubleshooting. You can also buy or order larger size flanges and see if they work better. Also make sure you’re not turning the suction on the pump too high; it should be as high as you can tolerate it, but not so high that it hurts.

other miscellaneous causes of sore nipples

Thrush (yeast infection)
Vasospasm
Flat or inverted nipples
Dermatitis
Nipple blebs
Engorgement, which may cause your nipples to flatten
If you have an older baby, your sore nipples may be caused by a lazy latch or teething
If you become pregnant while nursing, your nipples may become sore

Tips For Healing Sore Nipples

The key to managing sore nipples is to figure out what is causing the problem, and then addressing the problem directly.

GET SKILLED HELP

Very often, enlisting the help of a lactation professional can really help here, as they can usually help figure out what the issue is and offer hands-on helping in solving it.

Find an IBCLC near you.

FIX YOUR bABY’S LATCH

There are many ways to go about fixing a poor latch.

It can be very helpful to wait until your baby has a wide open mouth before latching them on.

You can also try shaping your nipple into a “C” or “U” hold, or making a “nipple sandwich” to help make your breast more manageable for your baby.

ADJUST YOUR POSITION

If breastfeeding hurts, try different positions!

Many moms have success using a “laid back” breastfeeding position, where they are reclined slightly back as their baby latches on. This helps “open up” their chest and gives their baby lots of rooms to try different angles to find a good, deep latch.

How To Heal Sore Nipples

If your nipples are already damaged, you can try to heal the skin with some at-home tips:

Wash your nipples with simple soap and water between feedings to prevent infection
Try soaking your nipples in a saline solution (1/2 teaspoon salt to one cup of water) after breastfeeding
Try a simple nipple cream and apply a protective coating after nursing; using a lanolin-based cream promotes healing and ensures that your nipples do not dry out and scab

See this Amazon product in the original post

Nurse on the less sore side first

Try cold packs between feedings
Go braless for a while and wear loose fitting clothing as the skin heals
If these things don’t work, consider asking your healthcare provider for prescription strength creams and ointments for nipple healing, such as antibiotic creams, anti-fungal creams, and anti-inflammatory creams
Ask your doctor for a breastfeeding-friendly painkiller to take

If your nipples are very damaged, you might need to pump for a few days or for a few feedings to allow your nipples to heal—pump as often as your baby nurses and feed them the pumped milk.

The Bottom Line

Let’s say it again: breastfeeding should not hurt! If you’re experiencing pain, it’s best to address this issue as soon as it begins, because nipple pain usually tends to get worse.

If you’re able, contact a breastfeeding peer counselor or a lactation consultant. They can help you identify the problem and give you tips on fixing it.

Most of all, don’t worry: There is light at the end of the tunnel, and once breastfeeding is less painful, it will be much more enjoyable!

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