Sore Nipples

Damaged nipples are pretty normal in the first 2 weeks of breastfeeding.  Think about it for a minute, you have never had anyone suck on your breasts this hard or this often before!  However, nipples are resilient and can handle a little trauma.  The key to it all is knowing that your nipples can heal while you keep feeding.  When you have the correct attachment breast milk is bathing your nipples while your baby is feeding, I can’t think of a better way to heal your nipples.  How amazing is our body!

If you can handle the immediate attachment then keep your baby on your breast.  You would only rest them and express if you couldn’t bare you baby on them.  But seek help if you are going to do this so you have a plan to get back on the breast without too much delay.

If you follow the guidelines of attachment above your nipples will settle down in the first 2 weeks.  After the initial damage your nipples will feel the same for about 5 days, no worse, no better then they will gradually feel better over the first two weeks.

Sore nipples beyond the first two weeks could mean there is something else going on.  Some of these problems include:

  1.  Thrush infection
  2.  Bacteria infection
  3.  Oral anatomy problems eg tongue tie
  4.  Vasospasm
  5.  Nipple shield use
  6.  Combination of all of the above

I will explain these briefly; however, it is important to seek advice if you have nipple damage beyond the first 2 weeks.

Nipples will heal well with just breast milk and sometimes a small amount of nipple cream will aid in healing put on after a feed.  However, if thrush or bacteria, found normally on our skin, enters the nipple from damage then healing can be delayed.  Both thrush and bacteria can be treated with guidance from your lactation consultant.

Anatomy problems of your baby’s mouth can also be a cause of sore nipples.  It is important to contact a lactation consultant for a full oral assessment.  Other health care professionals may not have the experience to assess your baby’s mouth, lactation consultants perform this daily and have been trained in this area.

Vasospasm is caused by consistent constriction of blood vessels in the nipple, usually from poor attachment but also may be due to oral anatomy problems.  You may feel an aching pain in your nipple and breast with feeding and without feeding also your nipple may change colour from white to purple and then back to pink again.  Warmth is a good remedy so if you see this colour change after a feed place a warm washer over your breast and nipple and see if this helps.  Again, this is best diagnosed by your lactation consultant.

Nipple shield use can cause many problems such as nipple pain and low supply.  If you purchase a nipple shield in the first 2 weeks it is important to touch base with a lactation consultant to discuss proper use.  Nipple shields do not protect your nipple from damage and your baby can damage your nipple through the shield.  Using a nipple shield is like a bandaid, it is better to find the source of your problem and fix that and then a shield may not be needed.