Your baby is hungry again, and you cringe. You know that it’s going to hurt as soon as you put him to the breast. What should you do? You may have heard that breastfeeding should never hurt – but it does for you. Or friends may say that it hurts for the first six weeks and you just need to grin and bear it. The truth is probably somewhere in between the two extremes. While many moms have pain-free nursing from the start, some new mothers do experience nipple soreness.
Ways to manage nipple soreness
Fix positioning and latch
Even one awkward latch in the early days of feeding can cause nipple soreness. If you’ve been nursing for a while, it’s possible that you’ve gotten relaxed and so has baby and this has caused a change in either the way you’re holding your baby or the way your baby is latching. Most of the time, nipple soreness can be alleviated rather quickly by simply being sure that you and your baby are well positioned, and that your baby is latching deeply onto the breast.
Be sure your baby is “tummy to mommy,” no matter what position you’re using. Hold your baby snugly against your body – with no space between the two of you. Your baby’s head should be at breast level. Use pillows under your baby or your arm if you need them. Wait for a wide-open mouth from your baby, and bring him to the breast (rather than leaning toward him to latch).
His chin should be buried in breast tissue, and his nose might be touching. He should have his lips flanged out on the breast, and you should notice his ear, shoulder, and hip are in a straight line (so he isn’t having to turn his head over his shoulder). His head should be slightly tipped back so that his chin isn’t against his chest (otherwise he won’t be able to swallow very well).
If it hurts, you can either wait to see if the pain passes as the feeding progresses, then try for a deeper latch next time. Or you can unlatch your baby and try again. If you need help getting your baby to latch comfortably, in-person assistance from a lactation consultant or trained breastfeeding counselor is your best bet!
Heal the nipples
No matter what caused the pain in the first place, it’s important to get your nipple healed. Many moms say that purified lanolin was helpful for them – it can be applied after every nursing session, and doesn’t need to be wiped off before baby nurses again.
Other strategies for healing include:
- Rubbing expressed breast milk into the skin of the nipple and/or areola right after a feeding,
- Trying a saline soak
- Using a natural oil, such as coconut, grapefruit seed extract, or olive, on the nipple (rather than lanolin),
- Placing a hydrogel pad over the breast after feedings (which will provide a moist wound healing environment as well as protect damaged nipples from clothing rubbing against them), or
- Protecting your nipples with breast shells. These are hard plastic domes that fit over your nipple and allow air to circulation while keeping clothing from touching the nipple. This may help with healing, though they can be uncomfortable for some women.
Another aspect to consider with nipple pain is whether or not there might be an infection. Thrush, a yeast infection, can cause shooting pain in the breast, as well as itchy, painful nipples and areola. It is typically treated with anti-fungal medication for mom and baby. It’s also possible to have pain from a bacterial infection, especially if you have any broken skin on your nipple. If your nipple pain doesn’t respond to any at-home treatments, you might want to consider checking with a lactation consultant or your doctor to see if an infection could be the cause of your soreness.
You may hear suggestions to use a nipple shield as a protective barrier between your nipple and baby’s mouth. The nipple shield, however, may cause additional problems, such as a nipple preference for baby or a low milk supply for you. And your nipple may rub in the inside of the shield, causing additional pain. On the other hand, if you’re ready to completely give up breastfeeding because of the pain, the nipple shield may provide you with some relief while maintaining your breastfeeding relationship. Work closely with a lactation consultant if you’re using a nipple shield.
If the pain of feeding is unbearable, sometimes resting your breast can be a temporary solution. This entails pumping on the painful side and feeding your baby only from the other breast, or pumping both breasts and feeding your baby expressed breast milk until your nipples heal. If you are doing this, you may want to use a method other than the bottle for feeding in order to avoid nipple confusion. Consider a soft-sided cup or medicine spoon for feeding. You’ll want to pump as often as your baby is feeding. Try pumping on the lowest suction setting so you’re not causing more nipple damage. Once you are healed, be sure to get help with latching so that the soreness doesn’t reappear once you start nursing again.
If your nipple is misshapen after a feeding, it could be that something about your baby’s anatomy that is causing your nipple soreness. A high palate, a tongue-tie or a lip-tie could be at the root of the issue. Your baby’s pediatrician can check to see if any of these could be the cause.
There’s no need to suffer through nipple soreness. Simple adjustments and treatments can make a huge difference. And so can the help of someone knowledgeable about breastfeeding, such as a peer counselor or lactation consultant. Be sure to get help if you need it so that you can enjoy nursing your baby and can meet your breastfeeding goals.