Sore, Cracked Nipples

Got a Sore or Cracked Nipple?

Sore and cracked nipples are one of the most common reasons why some women give up on breastfeeding. Nipple sensitivity in the beginning (first week or two) is normal, your nipples need to become accustomed to the extra attention. Some mothers also experience a bit of pain during the first few minutes while breastfeeding, when their babies latch on (this is normal).

Should my baby continue to breastfeed, if my nipples are bleeding?

The blood can not do anything to baby, even if the cut is infected, a mom can continue to breastfeed.

Reasons why you may have Cracked Sore Nipples

  • It may be difficult for a baby to latch on correctly, if the mother has nipple irregularities such as inverted/flat nipples.
  • The baby may have sucking problems that cause a bad latch. An uncomfortable breastfeeding position can also cause a bad latch. The mother's nipple should be positioned far back towards the soft palate of her baby's mouth. 
  • Thrush can cause pain and discomfort. 
  • milk blister / blocked nipple pore. 
  • Inflammation of a Montgomery tubercule (small knobs on the areola)
  • Vasospasm (read more about Raynauds syndrome here
  • Skin conditions like psoriasis, eczema or other infections like herpes.
  • Cracked or sore nipples are not always the cause of a bad latch.

Symptoms to look out for

    1. White “blanching” of the nipples/areaola.
  • Sometimes caused by a bad latch or sucking problems.
  • Vasospasms, which are the constriction of blood vessels. (Also sometimes called Raynauds phenomenon.)
  • The baby has a strong clenching reflex. Some premature babies may clench the jaw if anything enters the mouth. This is a problem that is usually outgrown within a few days. The other can wait until her baby extends his/her tongue to cover the gum ridge before latching on, and this could reduce the clenching. 

2. The appearance of the nipple and areolae.

  • It may look shiny, red, and flaky or might have something like a rash or white spots. The baby may also have white spots inside the mouth or have a yeast diaper rash. These are all signs of thrush. 
  • If there are no signs of thrush, you might have a blocked nipple pore “bleb”.
  • If there is a blister on the Montgomery tubercules, this can indicate an infection. You can use a warm compress and gently squeeze the area, to see if there is a milk blockage. If the infection is very bad, you will need to see a doctor for antibiotics.
  • A raised area of skin or red bumps can indicate that you might have other skin problems like eczema, herpes, dermatitis, psoriasis or have maybe come into contact with poison ivy.

General things to Consider

  • When you need to unlatch your baby, make sure you do so gently. 
  • Some ladies like to “rest” the nipple and give it a chance to heal, but it is recommended to continue to breastfeed, if possible. Breast shields can be used for short periods of time to help give the nipples a chance to heal. The main cause for the latch should be addressed too.
  • Breast shells keep your clothing away from the nipple and can help give your nipples a breather, but can sometimes also cause plugged ducts and skin irritation.
  • Breast milk is the best medicine for sore cracked nipples. Rub your own breast milk on the sore spots. Breast milk is antibacterial and will heal cracked nipples faster. Do not use breast milk for this reason, if you suspect that you have thrush. Yeast feeds on the sugar in milk. 
  • If the skin is badly broken, you can ask your doctor for a safe antibiotic ointment. 

How to Prevent Sore Cracked Nipples

  • Make sure that your baby is latched on well and that you are both comfortable while breastfeeding. Is my baby getting enough milk?
  • Wear bras made out of breathable fabrics such as cotton. Also avoid breast pads that are made with plastic liners. 
  • Avoid using soap to clean your nipples, water is fine. Do not use any products like perfume or powder on your breasts, these can cause drying and even infection. 
  • Do not rub your nipples in an attempt to harden them, this will only make the pain worse. Do I need to prepare my breasts for breastfeeding? 
  • Try to avoid the use of artificial nipples, these can cause suck issues. 
  • If you are using a breast pump, make sure that the flange fits your specific breast size.
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Tracy Behr, CBC, CLD (CBI)


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