Our current virtual pelvic floor rehab program is oversubscribed. Submit your email below to be added to the waitlist for our next program.
April 28, 2020
By Andrea Tran RN, BSN, MA, IBCLC
Sore nipples are a common complaint of mamas throughout their breastfeeding journey. Some degree of nipple soreness is experienced by the majority of women when they first start breastfeeding. This is true even of those moms who have picture-perfect positioning and use flawless latch technique. Fortunately, this is primarily a breaking-in period for their nipples and it will resolve quickly. New moms should know what they can expect from nipple soreness and what are red flags that something abnormal is occurring.
A lactation consultant should evaluate any nipple pain that is outside of these parameters.
Using correct positioning and latch technique is crucial for minimizing nipple soreness in the first few weeks of breastfeeding. The cross-cradle and football holds provide you with the most control and your baby with optimum support.
Your baby should be facing you with his tummy.
His nose should be directly across from your nipple.
Even though nipple soreness is common, it still can cause discomfort. There are a variety of remedies available that will provide moms with relief.
Tongue-tie, also called ankyloglossia or short frenulum, affects 4-11 percent of infants and can cause sore nipples. Babies who are tongue-tied may be unable to extend their tongue out far enough and this can result in extremely painful nursing. The nipple will often look flattened or misshapen after feeding. If the position and latch technique look good the mother/baby couplet should be evaluated by a lactation consultant. She can do an exam to see if the baby has any kind of tongue-tie. It is important to note that just looking at a baby’s tongue is not sufficient to determine if a tongue-tie is causing the pain.
If a baby appears to have a tongue-tie an Ear Nose and Throat doctor (ENT) or pediatric dentist can evaluate the baby to determine if a revision is indicated. Releasing a tongue-tie can be done with scissors or with a laser.
Babies who have dysfunctional or disorganized sucks can also cause significant nipple pain when feeding. They may be using their tongue incorrectly or they may be clamping down on the nipple. A lactation consultant can evaluate if this is happening by performing a suck evaluation. Time can help with these conditions. More severe cases may require working with a speech or occupational therapist who can help teach the baby how to suck properly.
A yeast infection on a mama’s nipples can cause burning and itching. The pain can be a mild soreness all the way to a stabbing pain. This is also referred to as nipple thrush. The nipples are often bright pink and may have a flaky appearance. They also can look normal so a diagnosis may be made based on symptoms alone. Treatment options include the application of Gentian Violet, which is an antiseptic dye that is used to treat fungal infections. It is available without a prescription but may be kept behind the counter in a pharmacy. Not every pharmacy carries it so call first. Prescription topical and oral antifungals are also used to treat yeast infections on the nipples.
Related: Thrush and breastfeeding
A condition called Raynaud’s Syndrome can cause intense nipple pain. This is caused by vasospasms of the blood vessels in the nipples. A telltale symptom is if a woman’s nipples turn white and then purple when the baby detaches. Treatment can be as simple as apply warm dry heat to the nipple as soon as the baby comes off. If that is not effective some mothers have found relief when a calcium channel blocker is taken. This is a prescription medication.
Teething can result in nipple soreness if a baby bites down on the nipple. Most babies will respond to being told a firm no!
Some moms will experience irritation when their babies begin solids. Having the baby drink some water will usually resolve this issue.
Nipple tenderness is also a common symptom of pregnancy. If no other reason for nipple soreness can be discovered it is worth taking a pregnancy test.
While there are many reasons for nipple soreness during breastfeeding, most will be temporary bumps in the road. Nursing moms should be reassured that there are effective remedies that will provide them with relief.
Walker, M. (2013). Are There Any Cures For Sore Nipples? Clinical Lactation, 4(3), 2013. Retrieved from https://simplesolutionsinternational.com/wp/wp-content/uploads/2017/03/Cures-For-Sore-Nipples-2.pdf
O'Shea JE, Foster JP, O'Donnell CPF, Breathnach D, Jacobs SE, Todd DA, Davis PG. Frenotomy for tongue‐tie in newborn infants. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.: CD011065. DOI: 10.1002/14651858.CD011065.pub2. Retrieved from https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011065.pub2/abstract
Andrea Tran RN, BSN, MA, IBCLC is a freelance writer who has been helping moms and babies breastfeed for over twenty-five years. She is married and the mother of three adult children.
MamaMend is the only digital health companion app for new moms that provides personalized, evidence-based answers and curated connections to expert practitioners.