Iowa Health Book: Obstetrics and Gynecology
Sore Nipple Management, Prevention and Treatment
Medela, Inc.
Peer Review Status: Externally reviewed by Medela, Inc.
Breastfeeding is meant to be a comfortable, pleasant experience. Most of us have heard stories of sore nipples. You can avoid this problem most of the time. However, many new mothers still find their nipples are tender for the first few days when the baby starts nursing. This usually disappears by 1-2 weeks.
Caution: blisters, cracking, bleeding and/or pain that continues during or in between feedings is not normal. Check with a lactation consultant, La Leche League, or Nursing Mother's Council if you have any of these problems.
Prevention
To prevent nipple tenderness, start with correct positioning and latch on:
Cradle position
- Place a pillow or two in your lap to support your baby.
- Place your baby's head on the crook of your arm.
- Make sure your baby is turned toward you - chest to chest - at breast level.
- Support your breast with your hand in an "L" or "C" position, thumb on top of breast, fingers below, away from areola.
- Tickle your baby's lower lip until he opens WIDE, then quickly pull him onto your breast. Be patient. This may take a minute.
- Make sure your baby's lips are behind the nipple, encircling the areola.
- The tip of your baby's nose should be touching the breast.
Football/Clutch position
- Put a pillow or two at your side to help support your arm and your baby.
- Support your baby's neck and the lower back of his head in your hand, with your forearm supporting his upper body against your side.
- Follow the steps 1, 2, 3, 4 under cradle position.
Lying down position
- Lie on your side with pillows supporting your back and your top leg, which is bent forward.
- Place your baby on his side facing you
- Follow the steps 1, 2, 3, 4 under cradle position.
Vary nursing positions for the first week.
Breastfeed frequently, every 1.5 to 3 hours (8 to 12 feedings per 24 hours.) Keeping your newborn baby on an artificially longer schedule may make him frantically hungry and increase the likelihood that too vigorous nursing will make your nipples tender.
Release the suction before you remove your baby from the breast. Do this by placing a clean finger in the side of your baby's mouth between his jaws. Don't take him away until you feel the suction break.
After nursing your baby, express a little breastmilk and massage it into your nipples and areola, then air dry. Leave them open to the air as much as possible.
Never use soap, alcohol, or breast creams on your breasts or nipples. Water is all that is needed to clean your breasts when you shower or bathe.
Management
If your nipples become sore, try this:
- Use deep breathing, soft music or other relaxation techniques before and during breast-feeding.
- Limit the nursing time on the sore nipple.
- Nurse on the least sore side first.
- Express a little milk first to stimulate let down.
- Massage your breasts while nursing. This helps stimulate the milk to flow.
- Use non-plastic lined bras and/or bra pads. Change the pads frequently to keep the nipple dry.
- If your nipples become dry or cracked, us a little USP Modified Lanolin on them. This forms a moisture barrier so they stay dry.
- If your breasts become engorged, try expressing a little milk first. Engorged breasts make it difficult for your baby to latch on. Expressing a little milk by hand or pump helps make the areola softer, nipple more erect and latch-on easier.
- Wear multiple holed breast shells for sore nipples between nursings. This allows air to circulate and protects them from further rubbing by your bra.
Medela, Inc.
PO Box 660, McHenry, Illinois 60051-0660
Phone (800) 435-8316 Fax (815) 363-1246
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