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Breastfeeding > Breastfeeding: Sore Nipples

Breastfeeding: Sore Nipples

It is not uncommon to experience some nipple tenderness in the first week of breastfeeding a new baby. Severe nipple pain or long lasting pain is not normal and needs to be treated.

Sore nipples may be caused by:

  • Your baby not latching on properly
  • Your baby not sucking properly
  • Improper breast care (such as washing your nipples with soap)
  • Improper pumping (such as pumping at high pressures or for longer than 15 minutes at a time)
  • Pumping with an incorrect size pumping flange
  • Nipples with yeast

Before feedings:

  • Wash your hands.
  • Make yourself comfortable and relax.
  • Express a small amount of breast milk by hand or pump to soften the areola (darker part of your breast around the nipple) and to stimulate the milk ejection reflex before your baby begins to nurse.

During feedings:

  • Offer the breast that is not sore first. Babies suck the strongest at the beginning of the feeding to help your milk let down.
  • Make sure your baby is properly positioned and you are supporting your breast properly.
  • Wait for your baby to open wide before latching. Make sure the baby is able to latch on to as much of the areola (darker part of your breast around the nipple) as possible in his mouth. Relatch if the latch is too sore and try to get baby on deeper.
  • Change the position of your baby at each feeding (cradle, football, side-sitting, lying down).
  • Nurse often — at least every 2 to 3 hours for 10 to 15 minutes.
  • When removing your baby from the breast, gently break the suction by inserting your finger between the baby’s gums and the breast. You should be able to hear the suction release.

After feedings:

  • Gently express a few drops of breast milk onto your nipples and allow to air dry.
  • If you use breast pads, be sure that they are not made of plastic. You can also use clean white handkerchiefs or cut maxi-pads.
  • Use a fresh breast pad after each feeding.
  • You may choose to apply a small amount of breastfeeding lanolin ointment to soothe your sore nipples. Do not use the lanolin if you are allergic to wool.
  • Lanolin does not need to be washed off before the next feeding.

Before pumping:

  • Wash your hands.
  • Make yourself comfortable and relax.
  • Properly center the breast shield on your nipples.
  • Decrease the suction pressure on the breast pump until your nipples heal.

After pumping:

  • Gently express a few drops of breast milk onto your nipples and allow to air dry.
  • If you use breast pads, be sure that they are not made of plastic. You can also use clean white handkerchiefs or cut maxi-pads.
  • Use a fresh breast pad after each feeding.
  • You may choose to apply a small amount of breastfeeding lanolin ointment to soothe your sore nipples. Do not use the lanolin if you are allergic to wool.
  • Lanolin does not need to be washed off before the next feeding.

Remember:

  • Breastfeed your baby before he is overly hungry or upset. This will help you relax and enjoy the feeding.
  • Avoid drying agents (soap or alcohol) on your nipples.
  • If your nipples are cracked, they may bleed when your baby is nursing or you are pumping. Your baby may spit up a small amount of this blood or you may notice pink tinged breast milk with pumping. A small amount of blood in your breast milk from a cracked nipple will not hurt your baby. Continued breastfeeding is encouraged. Consult your baby's health care provider to rule out other causes as well.
  • You may use acetaminophen or ibuprofen for discomfort (if you are not allergic to these medications).
  • Take care of yourself by getting enough rest, eating nutritious foods, drinking enough fluids and asking for help with your baby and household responsibilities.

This page is adapted from Children's Mercy Care Cards with help from the Lactation Nurses at Overland Park Regional Medical Center.

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