10 Reasons and Ways to Manage Sore Nipples from Breastfeeding

By Carey Haupt RD(SA) SACLC
Created: 1 October, 2019

Did you know that there are many reasons as to why your nipples could be sore because of breastfeeding? The most common reason is how your baby latches onto you but continue reading to find out other possible reasons and when to get professional help.

What causes sore nipples while breastfeeding?

There are four main reasons why you can have sore nipples while breastfeeding. They are:

  • a baby not latching well
  • chafing
  • thrush
  • adapting to this new skill

Prevention is definitely possible, and the treatment will depend on what the cause is. It is also possible to have a combination of reasons.

1.Check the Latch

The first step is to check the latch. This is the easiest of the sore nipple “problems” to fix. Breastfeeding can take time to learn and you may need to get a lot of practice. Checking your technique so that you are comfortable. Many babies and mothers need to practice getting the right latch. A healthy and comfortable breastfeeding latch is deep in the breast and helps to get most of your milk out while preventing pain.

There are many ways that a baby may have difficulty in latching. The most common problem is the shallow latch. Your baby’s lips should be around the dark area of your breast (not just your nipple). When your baby has a shallow latch, your nipple has pressure from the top of your baby’s hard pallet and the suction is very focused onto your nipple. A shallow latch can even cause bruising on your nipples.

Tips for a good latch:

  • Tickle baby’s upper lip with your nipple and wait until their mouth is wide open (like a yawn) before you gently guide them to the breast. Wait for your baby to open her mouth wide. If she does not open wide you will get a shallow latch
  • Pull them off and start over again if they don’t latch well at first. Use your pinky finger to break the seal. Place your pinky in the side of your baby’s mouth and gently pull your baby off. This helps to prevent your baby from biting down which stops the suction on your nipple.
  • If you deliver at the hospital, ask nurses to check your baby’s latch throughout your hospital stay. If you delivered at home, ask your midwife or doula for guidance.
  • You can use a nipple shield temporarily and under the guidance of a lactation consultant.

If you continue to have trouble, pain, or your baby seems frustrated while nursing, contact a lactation consultant. A licensed consultant can give personalized help. You can find a list of registered lactation consultants

2. Treat tongue tie, if needed

Persistently sore nipples can occur if your baby has a tongue-tie. If you are concerned that your baby has a tongue-tie, ask your lactation consultant for an assessment and referral to a Doctor who cuts tongue ties.

3. Adjust your hold

If you are sitting comfortably while feeding this will help you and your baby to have comfortable breastfeeding. There are many different breastfeeding positions. There are also many videos on U-Tube that you can watch.

The main tips are:

  • tummy to tummy so that your baby faces your breast. It is difficult to swallow if your head is turned at 90 degrees from forward.
  • Keep your baby’s ear, shoulder and hips in a straight line. This will help to keep your baby facing forward.
  • Use pillows, blankets or a footstool to help you feel comfortable.

4. Reduce Engorgement

Engorgement is when your breast feels full and even hard. Engorgement happens if you go too long between nursing, or if you’re still in the early stages and your supply is adjusting to the baby’s needs.

Engorged breasts may hurt. If your breasts are too hard it may prevent your baby from being able to latch on. You may need to release/ express a little bit of milk before you latch your baby on.

You can express a little milk to help soften your breast.

5. Thrush

Your nipples are often wet because of repeated breastfeeding. If your nipples are constantly or often wet this can result in thrush. Unfortunately, thrush is very contagious and can be passed on to your baby very easily. Thus if either of you has thrush both of you need to be treated for it by a doctor. If you are concerned that you may have thrush lookout for your nipple becoming pink, shiny and hurting. You may also feel a sharp shooting pain while breastfeeding.

To prevent thrush, dry your nipples between feeds. You can blow on or pat your nipple with a baby towel to dry, or you can walk around topless to air dry. Wash your nipples as per normal with a mild soap when you bath. Dry them properly after your bath. The use of disposable Breast pads are useful to help keep your nipple dry.

6. Moisturize your nipples

It is important to keep your nipples clean and dry but they also need to stay moisturized. They can be sensitive and crack and bleed during breastfeeding if they become too dry.

You can use Lanolin nipple creams. Before you decide to use a cream on your nipples make sure that it is safe for your baby as your baby will also take in the cream. Read product labels and ask your doctor which creams they recommend.

When using a nipple cream, clean the area with water then apply the cream straight after you have fed. This gives your nipples enough time to absorb it.

7. Choose the right size breast pump flange

If you are using a breast pump it is important that it fits you correctly and is comfortable. Using the wrong sized breast flange can cause your nipples to become irritated and sore. It can also affect the amount of milk you express when pumping.

You may need to change sizes as your breasts change over time, too. Always check that you have the correct size flange. Also, be sure to use a vacuum strength and speed that feels comfortable for you while pumping. Making the pump too strong will not result in more milk, but may hurt you.

8. Apply cool compress

Cool compresses/hydrogel pad can help soothe sore nipples after breastfeeding by reducing swelling. You can use a cool compress on your breast and nipple as well as under your arm.

Apply the compress a few minutes at a time. You can do this on and off for a few hours until the swelling is reduced.

A Hydrogel pad can help to soothe sore nipples. You can use them at room temperature or place them in the fridge. The pads also help to prevent your nipples from sticking to your bra or chafing on fabric.

9. Check for and treat Milk Blebs

A milk bleb is a blocked nipple pore. It appears as a small white or yellow blister on the nipple. A milk blister may go away on its own or it may recur.

You can try massaging it with olive oil. This helps to soften your skin. If you pick it, it may cause bleeding and infection. You can also try applying a warm compress and then hand expressing some milk to see if that releases the block.

Talk to your doctor if you have a painful, recurring blister.

10. Wear a supportive bra

Choose a bra that’s breathable to prevent chafing. If it’s hard to find a bra that fits consistently while you adjust to milk supply and breast size, look for nursing camisole tops that tend to have more stretch. Any restrictive clothing may cause pressure on your breast and cause you to have a blocked duct that can cause engorgement or mastitis.

Ask for help if you need it.

Nipple pain is common among breastfeeding women in the first few days. However, if the pain gets worse or does not resolve don’t wait too long for help. Your lactation consultant would be your first stop for assistance.