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Your question:

What can I do about sore nipples?

Expert’s answer:

A poor position or if your baby is not latching on well can cause nipple pain or sore nipples in the early days. Mums often describe the pain from a poor latch or poor sucking as ‘sharp, stabbing’. It hurts most as baby latches on and usually improves as the feed continues. Ask your midwife, public health nurse, local Breastfeeding Support Volunteer or Lactation Consultant to check your baby’s position and latch.

If your baby’s position and latch are okay, other causes of sore nipples include:

Cracks and splits

Poor latch and sucking may cause cracks or splits on your nipples. The pain may be ‘sharp, stabbing’ like from a poor latch but continue throughout the feed. Some tips for helping heal cracks and splits include:

  • After each feed, hand express some milk and gently rub into they nipple area and leave to air dry.
  • Gently massage your nipples with warm fingers and 100% lanolin nipple ointment. Make sure you are in a warm room.
  • Spread a small amount of 100% lanolin nipple cream on a clean dry breastpad and place over the nipple. Change breastpad frequently to prevent moisture staying on your skin.
  • Use a hydrogel compress – ask your pharmacist for details.

If it feels too painful to feed, some Mums find that pumping their milk for a day or two allows their nipples time to heal, and they get to continue giving breastmilk to their baby. Hand expressing may be more comfortable than using a pump. If you do use a breastpump, start on the lowest setting and increase it slowly to the lowest setting at which your milk starts to flow well.

Thrush

Thrush is a fungal infection. The pain often goes on throughout the feed and may continue even after the feed is over. Mums often describe this type of pain as a ‘burning sensation’. You or your baby may be likely to develop thrush if you’ve taken antibiotics recently. You might notice white spots or plaques on the inside of your baby’s mouth, and your nipples may be red and shiny. Having thrush does not mean you need to stop breastfeeding. If you think you may have thrush you need to contact your GP to discuss treatment for you and baby.

   <Summary of common treatments for thrush from medication piece.>

Vasospasm

Vasospasm is due to irritation of the blood vessels in the nipple – usually by whatever is causing the nipple soreness in the first place (poor latch/sucking or infection).

Mums who experience vasospasm find that their nipples turn white and sore after a feed. Mums often describe this pain as ‘burning’, and it generally only begins after the feed is over. It may last several minutes or more after which the nipple returns to it’s normal colour. At this stage a new pain develops, often described by Mums as ‘throbbing’ and it may last for seconds or minutes. Occasionally this will repeat.

A small number of mums may experience vasospasm as a result of Raynauds Phenomenon. This is caused by vascular constriction, when the very small blood vessels constrict and the affected area becomes white and sometimes cold. Areas of the body commonly affected include tips of fingers and toes as well as nipples.

If you think you may have vasospasm you contact your midwife, public health nurse, local Breastfeeding Support Volunteer or Lactation Consultant for help to identify the cause.

If you are experiencing vasospasm:

  • Pay careful attention to latching on, ask your midwife, public health nurse, local Breastfeeding Support Volunteer or Lactation Consultant to check how your baby is latching on and sucking.
  • Heat to the nipple immediately after feeding may help prevent or reduce the severity of the reaction. Dry heat (hair dryer or hot water bottle wrapped in a towel) is usually better than wet heat (hot facecloth).  

       <  Self-help tips>

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