During the first few weeks after your baby’s arrival, you may develop sore nipples as the baby is adjusting to sucking. This condition is common and does not warrant medical intervention. However, if you have cracked nipple skin with or without pain, which is not improving over the next two weeks, it would be wise to talk to a lactation consultant (1). During the consultation, before any medical treatment, the doctor might ask you to try some home remedies.
In this MomJunction post, you provide all the information you need about sore nipples causes, treatment, home remedies, and more.
What Cause Sore Breasts When Breastfeeding?
Here are the leading causes of soreness and pain in the breasts of lactating moms:
- Stretching of the nipple: Your nipple will stretch and extend during the first few days of breastfeeding. The sensitive nipple, as well as the areola skin, can become sore due to the baby’s sucking action during the feed. This is a common phenomenon and will subside eventually (2).
- Poor latch: A poor latch can cause the nipple to bruise, redden, and even crack, and result in pain (3). To prevent or treat this condition, ensure latching is proper.
- Thrush: Thrush is a yeast infection caused by the Candida fungus and is a common cause of painfully sore nipples. Yeast appears as white, red, pink or shiny patches on the nipple and areola (4).
- Mastitis: Mastitis is the accumulation of milk in the milk ducts and causes painful engorgement of the breast (5). If bacteria enter the milk ducts through the cracked nipple, then you can get infective mastitis that leads to the soreness of the breast and cause extreme discomfort while breastfeeding. You may have flu-like symptoms.
- Eczema: Eczema, medically called dermatitis, is a group of inflammatory skin conditions. Of the many variants of eczema, contact dermatitis is one that you can get because of constant friction or allergic reaction to detergent (6). This constant friction due to breastfeeding, sometimes causing eczema, which could lead to pain and soreness of the breast (7).
- Ringworm: Ringworm is a fungal infection and occurs when opportunistic fungi settle on the constantly moist skin to multiply and thrive (8). If it happens on the breasts, especially around the nipple, then it is quite likely to feel itchy and sore in the region.
Home Care And Preventive Measures For Nipple Soreness?
Here are a few home remedies to manage and prevent or relieve discomfort due to sore breasts:
- Ensure that the baby latches and unlatches correctly and maintains suction around the entire areola region and not just the nipple. You can follow a few tips to help your baby latch well or consult a lactation technique to learn about the right techniques to get your baby to latch well (9).
- Avoid keeping breasts too full of milk (engorgement). This happens when regular feeding is not done, or breasts are still adjusting to the baby’s needs. It is crucial to avoid this situation as sore breasts generally hurt more when they are full (10). At times even latching becomes difficult when you can try expressing the breast milk to get some relief. You can express milk manually or use a breast pump to do the same.
- Feed from one breast at a time and ensure that you empty one breast before switching to another. It prevents milk stasis, which is an accumulation of milk within the milk ducts. Milk stasis increases the risk of mastitis, which can increase the risk of infection that leads to soreness and pain in the breasts.
- Check and treat milk blebs to relieve sore nipples, which are often a result of clogged nipple pores. For this, massage your breast with lukewarm olive oil or use a warm compress and apply it over the blister. While you do so, do not try to puncture the blister as it may lead to infection.
- Prompt treatment of thrush is recommended to prevent recurring sore nipples. This could be done by drying the nipples after every feed. The ideal method would be to clean the nipples before and after feeding and pat them dry after that. You can check with your doctor about suitable nipple creams.
- Use the right-sized breast pump, in case you are using one. It is crucial as over time, the breast size might change. Using the wrong-sized breast pump can irritate your nipples, leading to soreness. Follow a breast pump guide to use it. Be sure to use a vacuum strength and speed that feels comfortable to you while pumping. Making the pump too strong might hurt the nipples too.
- Use purified lanolin cream, which is safe for application on the nipple and can help prevent cracking and dryness of the areola. One hundred percent purified lanolin, without any additives or fragrances, does not harm the baby. Also, there is no need to remove the cream from your nipple before breastfeeding.
- Use nursing pads to keep nipples dry, since a small amount of milk may drip out after breastfeeding. It can cause a moist environment that allows fungi to propagate. Use nursing pads to trap the milk and prevent excess moisture.
- Use hydrogel pads as they could help in relieving pain caused by sore or cracked nipples. These pads can be used at room temperature or could be kept in the refrigerator before use. They also prevent your nipples from sticking to the bra fabric, which could further irritate the nipples.
- Wash breasts with mild soap, especially one recommended for sensitive skin and with added moisturization, to keep the breast skin and areola hydrated. It can be especially helpful if you have eczema on your breasts. Using strong detergent-like soaps or soaps with chemicals can irritate and may exacerbate dryness of the nipple.
- Dress in comfortable bra and clothes, as uncomfortable or tight clothing may cause soreness of breasts due to excess pressure on the breasts. Wear clothes that are comfortable and allow your skin to breathe.
- You could use acetaminophen or ibuprofen if the pain is too much. However, being a breastfeeding mother, you must ensure the safety of these medications before use (11).If soreness in the nipples is persistent, then you could check with a lactation consultant about the possibility of tongue-tie (12). Most cases of soreness are benign and seldom a cause of concern. But in some cases, a visit to the doctor is necessary.
When To See A Doctor For Breast Soreness?
See the doctor right away when you experience the following symptoms of breast soreness:
- Burning and severe itching of the breast that interferes with breastfeeding.
- Cracked and bleeding nipples.
- Yellow or clear fluid discharge from the breasts.
- The pain radiates across your shoulders, neck, or across the chest.
- The pain is very sharp, and the breasts are painful to the touch. Even a little pressure causes pain.
- You notice a change in the shape and color of your breasts.
- You notice a hard lump within the breast.
The doctor suggests the ideal treatment based on the diagnosis.
How Are Sore And Painful Breasts Treated?
Your doctor decides the treatment after the assessment of symptoms and diagnosing the underlying condition. The following are the various treatment methods for sore and painful breasts when breastfeeding.
- Oral and topical antifungal medications may be prescribed to treat thrush both for you and the baby. Your doctor may prescribe medications that are compatible with breastfeeding.
- Ointments, creams, and lotions help ease conditions like eczema and minimize stretching of the skin due to breastfeeding.
As sore nipples are usually benign, home care and management are usually enough to manage them during breastfeeding.
Soreness and pain in the breasts when you are breastfeeding is temporary and seldom causes lasting complications. Managing the condition at home usually alleviates the symptoms and makes it better. Taking precautions and maintaining breast hygiene can minimize the risk of sore breasts. However, if you find any particular symptoms that are bothersome, consulting a doctor is wise.
Have something to share about soreness and pain in breasts while breastfeeding? Tell us in the comment section below.
2. Sore Nipples; University of Michigan
3. Sore Nipples; University of Rochester Medical Center
4. Breastfeeding and thrush; National Health Service, UK (2018)
5. Mastitis; National Health Service, UK (2018)
6. Contact Dermatitis; National Eczema Association
7. Common Breast Problems; Michigan Medicine, University of Michigan
8. Ringworm (Tinea). Harvard Medical School
9. Breastfeeding: positioning and attachment; National Health Service, UK (2019)
10. Breast Engorgement; Michigan Medicine, University of Michigan
11. The Transfer of Drugs and Other Chemicals Into Human Milk. The American Academy of Pediatrics
13. Tongue-tie; National Health Service, UK (2017)