Sore nipples are the last thing that you need while breastfeeding and yet, that's exactly when you're most prone to them. The constant suckling and tugging of your breasts can often leave your nipples feeling a little raw, and sometimes even cracked and damaged.
Luckily, there are many ways to prevent nipple pain and get back to enjoying that special bonding time with your baby.
Are your nipples supposed to hurt while breastfeeding?
Breastfeeding shouldn't be a painful experience and your nipples aren't supposed to hurt the whole time. While it's normal to experience some tenderness and discomfort in the first few days of breastfeeding, the pain shouldn't hang around for too long.
Unfortunately, it's quite common for women to experience nipple pain at different stages of their breastfeeding journey. Some women breastfeed comfortably for months before suddenly experiencing an onset of pain while others have felt a varying degree of pain the entire time.
Whether it's your first baby or your fifth, experiencing any type of nipple pain while breastfeeding can frustrating and sometimes even enough to discourage you from breastfeeding at all.
But before you give up too soon, let's take you through a few reasons why you might be experiencing sore nipples.
What causes breasts to hurt when breastfeeding?
Poor latch
One of the common causes of breastfeeding pain is a poor latch. In breastfeeding, the latch or attachment refers to the position of the baby's mouth on the mother's breast.
A poor or shallow latch is when the baby's mouth is positioned on the nipple rather than the breast. This can cause your baby to squash your nipple as they feed, leading to pinched and painful nipples and even a restricted flow of milk.
In a good latch, your baby's mouth should be wide and taking in a large portion of your areola into their mouth. Their chin should be against your breast with their nose turned upwards.
Your nipple will be gently pressed against the roof of their mouth with their tongue cupping underneath. Once your milk starts flowing, your baby should be taking slow sucks with some pauses for swallowing.
Getting the hang of a good latch can take some time and it's always worth getting your latch checked by a healthcare professional or lactation consultant.
Breast engorgement
Breast engorgement occurs when the breast tissue overfills with milk and other fluids.
It usually happens if your breasts aren't drained properly after a feed, which can happen if your body is making more breast milk than your baby needs or if your baby isn't attaching and feeding properly.
Usually, breast engorgement happens in the first few days and weeks of breastfeeding, when your body is still adjusting its milk supply and getting the hang of breastfeeding.
Breast engorgement can cause considerable pain, often making your breasts feel very hard, swollen and full. Your nipples may also become flat or tight, making it harder for your baby to attach and relieve your symptoms.
The only way to relieve breast engorgement is by emptying the breast. You can do this by feeding, expressing or using a breast pump.
You can also apply a warm washcloth or take a warm shower before feeding to help stimulate the milk flow.
Milk letdown
Milk letdown refers to the process that releases the milk from your breasts. When your baby attaches to your breast, the nerves in your nipple cause hormones to be released into your bloodstream.
Some women don't feel anything when their milk lets down but other women experience a wide variety of sensations, including:
- Tingling
- Burning
- Warmth
- Pressure
- Pins and needles
In the weeks after giving birth, you may even feel some uterine cramping. This is because oxytocin triggers the muscle contractions that help shrink your uterus back down to its normal size after birth.
Clogged milk ducts
Milk ducts are the thin tubes in the breast that carry breast milk from the mammary glands to the nipples. If the milk duct isn't drained properly during feeding, a buildup of breast milk can block the duct and cause significant pain.
You might have a clogged milk duct if one or both of your breasts are experiencing any of these symptoms:
- Pain in a specific area
- A tender lump
- Heat and swelling
- Slower milk flow in one breast
- Lumpy skin in a specific location
You can attempt to unclog a milk duct by massaging the affected area during nursing or while taking a warm bath or shower.
Mastitis
If a clogged milk duct isn't cleared, it can lead to a breast infection called mastitis. Mastitis can cause a fever, body aches and severe breast pain.
Along with a blocked duct, mastitis can also be brought on by bacteria that has entered the breast through cracked nipples.
It's important to see your doctor or healthcare provider if you suspect you have mastitis. They will suggest the best treatments for the infection or even prescribe a short course of antibiotics.
What causes sore or cracked nipples when breastfeeding?
Nipple sensitivity
Your nipples are usually sensitive in the first few days after birth and become less sensitive as you get used to breastfeeding. However, your nipples might feel sensitive if they undergo nipple trauma from a poor latch, aggressive suckling or the incorrect use of a breast pump.
If your nipples are sensitive, they are more vulnerable to cracks and usually experience more pain during breastfeeding.
You can reduce sensitivity by helping your baby to form a deep latch with your breast and caring for your nipples in between feeds.
Nipple blanching and vasospasm
Nipple blanching refers to white, painful nipples that are usually caused by a sensation known as nipple vasospasm. Nipple vasospasm is when the blood vessels supplying blood to your nipple spasm during or immediately after breastfeeding.
It generally happens if your baby isn't latching to your breast properly. In a shallow latch, the pressure of your baby's mouth against your nipple can prevent the blood from flowing to the area.
Usually, nipple vasospasm is worse when you're feeling cold or if you have a history of Raynaud's phenomenon.
To prevent nipple vasospasm and blanching, you should avoid exposing your nipples to cold air and keep your breasts warm by using breast pads, warm clothing or a heat pack after breastfeeding.
Teething
Breastfeeding can come with some literal teething issues and unfortunately, it's your nipples that catch the brunt of it. When your baby begins to teethe, the increased saliva and enzymes in their mouth can irritate your nipples.
The best way to prevent sore nipples when your baby is teething is to rinse the baby's saliva off your nipples immediately after breastfeeding.
Thrush
When you breastfeed, you become more prone to breast and nipple thrush. Thrush can occur if you have cracked or damaged nipples as it becomes easier for fungus to enter your nipple and breast.
It might also occur if you have recently taken a course of antibiotics. The unpleasant fungal infection can cause severe burning pain in your nipples during breastfeeding and considerable pain afterwards.
You may also experience sharp, shooting and stabbing pain throughout the breasts. Thrush is usually treated with a combination of anti-fungal cream and tablets.
Milk blebs or blisters
A milk bleb or blister is when breast milk gets trapped under the skin. It usually occurs when the baby is not attached properly and puts too much pressure on a particular part of your breast.
Milk blebs and blisters usually look like a small, white dot under the skin and sometimes it might also be pink or yellow in colour. Milk blebs are usually resolved by feeding the baby from the affected breast but in some cases, may need further medical assistance.
Pain from pumping equipment
Breast pumps can take some getting used to and if you're experiencing nipple pain while using pumping equipment, you might not be using it correctly. If there's too much suction from the breast pump, you can injure the top of your nipple and restrict your milk supply.
The wrong size breast pump flange can also irritate your nipple and areola.
Dry skin
If your baby has a strong or aggressive suckle then your nipples might become sore, chapped and dry. Dry nipples are more prone to cracks, which can then lead to further infections and pain.
You can usually manage dry nipples with a good quality ointment like Kin's Nipple Balm, which restores sore nipples, soothes skin and prevents nipple cracking.
How to prevent and stop nipples hurting when breastfeeding
Nipple pain can make breastfeeding very uncomfortable but there are a few ways to prevent and reduce nipple pain to ensure that you have a more comfortable and enjoyable breastfeeding experience.
Preparing for a feed
Preparing your breasts and nipples for a feed can help you feel more relaxed and reduce any nipple pain that you're experiencing.
Before a feed, you can try:
- Taking a warm shower or using a warm washcloth on your breasts
- Giving your breasts a gentle massage to stimulate your milk flow
- Help yourself feel relaxed by doing some deep breathing or listening to music
- Expressing a little milk to lubricate the nipple
- Offer a feed before your baby gets too hungry to reduce the intensity of their suckle
During the feed
Breastfeeding can ease some types of nipple and breast pain if the baby is correctly latched.
If you're struggling with latching techniques, you might want to consider reading more about baby-led attachment or speaking to a lactation consultant for hands-on help.
During the feed, you can also try:
- Starting the feed on the less sore side
- Checking the baby is properly latched to your breast
- Avoiding any nipple pinching by pulling the baby in closer, leaning back and checking the baby is positioned in a straight line
- Trying different breastfeeding positions
- Giving the affected breast a 12 to 24-hour break and express your milk instead
- Using a nipple shield, which is a silicone device you place over your own nipple to help your baby latch and protect your nipple.
Aftercare
It's important to help your nipples heal and recover between feeds. You can do this by wearing loose clothing, using breast shells and by applying nourishing creams and ointments.
The Nipple Balm by Kin is an all-natural formula that soothes and restores sore nipples. The balm's nourishing combination of avocado oil, lanolin and shea butter work together to build skin elasticity and prevent painful chafing and nipple cracking.
The balm is even safe enough to leave on between feeds, meaning you don't have to worry about wiping it off and can spend more time snuggling your baby.
If your nipple pain doesn't ease, be sure to access breastfeeding support through a doctor, lactation consultant or an Australian Breastfeeding Association Counsellor.
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