Coping with Breastfeeding-Related Nipple Soreness

If you're breastfeeding and are experiencing painful nipples, it can feel like you're all alone. But don’t worry, lots of parents go through nipple soreness at some point in their breastfeeding journey.

Although breastfeeding shouldn’t be painful, we know that cracked, bleeding, or itchy nipples do happen, and they can be really uncomfortable and upsetting.

So, we've gathered some tips and advice to help ease your discomfort and make your breastfeeding journey a little smoother. Read on to learn more about causes and treatment for sore nipples when breastfeeding.

What causes sore nipples when breastfeeding?

There are a few different things that can lead to sore nipples when breastfeeding. These include…

• An improper latch. This can be caused if your baby has a tongue-tie, or if you have nipples that are flat or inverted.
• Blisters on your nipples can be painful. These are usually caused by friction and appear as sore white spots due to blocked milk ducts.
• Wearing the wrong bra can add extra pressure on your nipples and make them painful.
• Removing your baby from latch too early. If your baby is removed from the breast before the suction of their latch is broken, this can be painful and potentially cause breast tissue damage.
• If you have a dry skin condition like eczema, you should ask a health professional's advice on medication that’s safe to take when you're breastfeeding. 
• Irritants from soaps, perfumes, or detergents can cause skin irritation, and can sometimes worsen sore nipples if they're already cracked.

There are also some other causes of sore nipples that are less common and may need treatment from a medical professional. These include…

• Vasopasm – Constriction of the blood vessels in the breast.
• Mastitis – A breast infection from blocked milk ducts.
• Thrush – A contagious yeast infection.
• Staphylococcus aureus – The most common bacteria associated with infection in damaged nipples.

How can I relieve sore nipples from breastfeeding?

Finding the right type of relief for your sore nipples depends on what's triggering the discomfort in first place.

Here are some ways to alleviate nipple soreness and discomfort caused by breastfeeding…

• Ensuring your baby is properly latched on when feeding. Once baby's latch is improved, your sore nipples should heal on their own.
• Making sure you break the suction of their latch before removing your baby from the breast.
• Trying different breastfeeding positions to see if they work better and are more comfortable for you and baby.
• Changing your breast pads after each feed.
• Wearing soft, cotton nursing bras that fit correctly.
• Avoiding irritants in soap or detergents. Instead, use ordinary mild soap – not antibacterial.
• Dabbing expressed breastmilk onto your nipples after feeds.
• Applying a warm water compress to soothe your nipples.
• Applying a cold compress or chilled cabbage leaves can soothe sore breasts.
• Using silicone nipple shields when breastfeeding to protect your nipples.
• Applying nipple cream to soothe sore nipples.
• Taking breastfeeding-friendly painkillers or anti-inflammatory medication. Ibuprofen and paracetamol are compatible with breastfeeding. But if you're not sure if a painkiller is compatible with breastfeeding, consult a pharmacist for reassurance.

Should I reduce or stop breastfeeding if I have sore nipples?

If you can, it's best to persevere and try to continue breastfeeding regularly to maintain your milk supply. Expressing your breast milk manually or using a breast pump and then feeding your baby with a bottle can help by giving your nipples a break and time to heal.

Even in the case of a breast infection like mastitis, it’s best to continue breastfeeding if you can, unless you've been advised otherwise by a health professional. The antibodies in your milk help to protect your baby from infections.

What can I do if my sore nipples don’t get better?

If you're experiencing pain when feeding or sore nipples that are not healing, you should ask for help and advice from your health visitor, doctor, or a IBCLC lactation consultant.