Sore or painful nipples are one of the main reasons women give up breastfeeding. But with the right help and support, this problem can often be sorted out.
Sore nipples are most common about three to seven days into breastfeeding. It usually happens because your baby isn't positioned and attached effectively at the breast.
"As women and babies learn the skill of breastfeeding and become more confident, they often report that the pain gradually improves," says Zoe Ralph, an infant feeding worker in Manchester and Fellow of the Institute of Health Visiting.
You'll be supported with positioning and attachment and shown the signs your baby is feeding well soon after birth. This should happen before you leave hospital or the birth centre, or, if you have your baby at home, before your midwives leave.
Get help early for sore nipples
You may feel strong sensations as your baby starts to suck, but pain when breastfeeding isn't normal. "Putting up with it could make things worse and affect how you feel about breastfeeding your baby," says Zoe Ralph.
If you find one or both nipples hurt at every feed or your nipples start to crack or bleed, it's important to get help from a breastfeeding specialist as soon as you can. They can watch as you feed your baby, and help you get them correctly positioned and attached to the breast.
When your baby is effectively attached, your nipple rests comfortably against the soft palate at the back of their mouth. If your baby is poorly attached to the breast, the nipple is nearer the front of the mouth and can be pinched against the hard palate, causing pain.
Flattened, wedged or white nipples at the end of a feed are one sign your baby may not be properly attached. Your baby may also seem unsettled after feeds.
Having sore nipples when you're trying to breastfeed a new baby can be stressful and upsetting. "Try to carry on breastfeeding or doing hand expression if you can and ask for help early," says Zoe Ralph.
Learn more about expressing milk by hand.
Find out where to get help and support with breastfeeding.
Self-help tips for sore nipples
Bear in mind that self-help tips won't be effective if your baby is poorly attached during breastfeeds. However, you may find it helps to:
- hand express a little milk at the end of a feed so a drop or two can be gently massaged on to your nipple
- let your nipples dry before getting dressed again
- if you use breast pads, change them at each feed – if possible, use pads without a plastic backing
- don't use soap, as it dries out your skin
- wear a cotton bra so air can circulate
- wear a non-underwired bra, ideally one designed for breastfeeding
Some women treat any cracks or bleeding with a thin smear of white soft paraffin, such as Vaseline.
"The evidence for this is inconclusive and some women can also have a reaction to the product they are using," says Zoe Ralph.
"The nipples won't heal anyway if positioning and attachment isn't corrected, so early help from a breastfeeding specialist is essential."
It probably won't help to:
- keep breastfeeds short to "rest" your nipples – this won't ease nipple pain, and could affect your milk supply and leave your baby dissatisfied after feeds
- use nipple shields (a thin, protective cover worn over your nipple as you breastfeed) or breast shells (a hard, protective cover worn inside your bra) – these won't improve your baby's attachment to the breast
It's important not to stop breastfeeding. With the right help, you should find breastfeeding quickly becomes more comfortable again.
If nipple pain still doesn't improve
If your baby is properly attached and positioned to the breast during feeds and your nipples are still sore, ask your midwife, health visitor or a breastfeeding specialist to observe a full breast feed.
"There may be an underlying reason, such as thrush, that may be causing a further challenge," says Zoe Ralph.
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