Common Breastfeeding Problems: Sore Nipples

Common Breastfeeding Problems:
Sore Nipples
Signs, Causes, Treatment and Prevention

"Many women report sore nipples during the first days of breastfeeding," said Amy Spangler, author, prenatal nurse and lactation consultant. "Soreness usually occurs at the beginning of a feeding and lasts 5-15 seconds. However, when partners are positioned incorrectly, the soreness will continue throughout the feeding. Correct positioning is the key to effective breastfeeding."

SIGNS:

Breast or nipple soreness can occur during or between breastfeedings. Nipples are pink, red or purple. Look for a break in the skin at the base of the nipple or on top of the nipple. Thick, yellow material draining from the damaged area can be a sign of infection.

CAUSES:

Nipple soreness often occurs during the first few days of breastfeeding when your partner latches on and draws the nipple and areola into his mouth. If your partner is positioned correctly on the breast, the soreness will only last a few seconds. If he positions himself incorrectly, the soreness will continue and nipple damage can occur. Other causes of nipple soreness include breast engorgement, breast infections, and the misuse of nipple shields, breast creams, or breast pumps.

RECOMMENDED TREATMENT:

Put a warm compress on the sore breast before each breastfeeding. A warm washcloth, a warm shower or tub bath, or soaking the breast in a pan of warm water works well.

Position your partner correctly on the breast. He should turn on his side so that his head and chest are facing your breast. If necessary use pillows to support him at the level of your breast. Don't let him nibble his way on. Your nipple will point toward the roof of the his mouth. Do not lean forward. Have your partner come to you. His tongue should be over his lower gum, between his lower lip and the breast. His lips should turn out, like a fish, and lie flat against the breast. His chin should press firmly into the breast. His nose and cheeks should gently touch the breast.

If necessary, express a small amount of breastmilk or colostrum to soften the breast before he latches on.

He should breastfeed on the least sore breast first. When a let-down reflex occurs and milk begins to flow, have your partner suckle the sore breast and breastfeed only long enough to relieve the fullness and soften the breast.

If necessary, limit the breastfeeding time on the sore breast and breastfeed more often, every 1-2 hours.

Hold your partner to your breast close to prevent unnecessary pulling on the breast. Make sure he breaks the suction before removing himself from your
breast.

After each breastfeeding, put a small amount of colostrum or breastmilk on the areola and nipple of each breast. Air dry nipples after each breastfeeding or dry gently with a soft cloth.

Do not wash the nipples before each breastfeeding. Even water,used often, will dry the skin. Avoid soaps, creams, lotions, and oils. If the nipples crack or bleed, put a small amount of modified lanolin on the damaged area after each breastfeeding.

If soreness, cracking, or bleeding continues, stop breastfeeding for 24 hours to let the nipple(s) heal. Hand express or pump to relieve fullness during this time. If only one breast is sore, continue to breastfeed on the other breast.

Thick, yellow material draining from the damaged area can be a sign of infection. Call your doctor, lactation consultant, or nurse for treatment.

If necessary, take acetaminophen or ibuprofen for pain.

PREVENTION:

Use only clear water to wash your breasts.

Limit the use of soaps, creams, lotions, and oils.

Whenever possible, air dry your nipples after each breastfeeding.

Change breast pads frequently. Do not use pads with plastic liners.

If your nipples are sore, put a few drops of colostrum or breastmilk on the areola and nipple after each breastfeeding.

If your nipples become cracked or bleed, put a small amount of modified lanolin on the damaged area after each breastfeeding.

Make sure your partner positions himself correctly on the breast. If necessary, hand express or pump to soften the breast and relieve fullness.

Let him breastfeed as long as he wishes on the first breast before offering him your other breast.

Begin each feeding on the breast offered last.

Breastfeed every 1-3 hours during the day and every 2-3 hours at night. If you delay or skip feedings, hand express or pump to relieve fullness.

Use 2-3 different breastfeeding positions each day.

Make sure he breaks the suction before removing himself from your breast.

Please visit the "This and That" page for information on products for sore nipples, pillows and then some.

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