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 Moms also experience a bit of pain for the first few minutes while breastfeeding, when baby latches 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
• Engorgement. When the breasts are too full, baby might struggle to get a good latch.
• Baby may have sucking problems that cause a bad latch. An uncomfortable breastfeeding position can also cause a bad latch. Mom's nipple should be positioned far back towards the soft palate of baby's mouth.
• Thrush can cause pain and discomfort.
• A milk blister / blocked nipple pore.
• Inflammation of a Montgomery tubercule (small knobs on the areola)
• Vasospasm (read more on 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:
White “blanching” of the nipples/areaola
• 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. Mom can wait until baby extends his/her tongue to cover the gum ridge before latching on, and this could reduce the clenching.
The appearance of the nipple and areolae
• If mom does not have signs of thrush, she might have a blocked nipple pore “bleb”
If there is a blister on the Montgomery tubercules, this can
indicate an infection. Mom can use a warm compress and gently squeeze
the area, to see if there is milk blockage. If the infection is very
bad, she will need to see a doctor for antibiotics.
• A raised area of skin or red bumps can indicate that mom might have other skin problems like eczema, herpes, dermatitis, psoriasis or has maybe come into contact with poison ivy.
General things to consider
• When you need to unlatch 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.
• If the skin is badly broken, mom can ask her doctor for a safe antibiotic ointment.
How to prevent sore cracked nipples
• Make sure your baby is latched on well and that you are both comfortable while breastfeeding. Read more on "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.
• Avoid using artificial nipples, these can cause baby to suck differently.
• If you are using a breast pump, make sure that the flange fits your specific breast size.
Tracy Behr, CBC, CLD (CBI)
Course information on breastfeeding problems/cracked, sore nipples.
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