Sore Nipple Management for the Breastfeeding Mother

Sore nipples associated with breastfeeding, is with out a doubt the most common reason women quit breastfeeding. Their are so many nerve endings in our nipples, that when they become red, cracked, or heaven forbid begin bleeding, it can result in  literal toe curling pain. I remember in vivid detail, looking at my second daughter who did quite a number on my nipples, dreading each feed knowing full well it was going to be excruciating. I remember thinking this pain is nothing compared to what I just went through with labor!! I was ready to throw in the towel, but thankfully with the help of some wonderful mentors and Lactation Consultants, I was able to muster through and with their help, saved my breastfeeding experience.
Unfortunately it only takes one bad latch to damage your nipples. The most important thing to do at that point is to figure out what is causing the painful latch. It is a huge misconception that breastfeeding is supposed to hurt. That could not be further from the truth! Yes your nipples are probably receiving more friction then they are used to, but it still should not be hurting. I have had women call me thinking something was wrong, that their babies must not be eating because their nipples looked normal, and not in pain. That is how it should be and could be for you.

We can fix your sore nipples, treat them, and heal them…but we must first fix the root cause of them. It could be a baby issue or it could me a mom issue, or it could be both. There are many reasons why nipples become sore. If this is you, I would look into visiting a Lactation Consultant to view a feeding and help find a good solution to eliminate the constant gnawing of your babies food source. One quick fix you can use, is looking to see if you are latching your baby correctly. In my previous post “Latching a baby in 7 Simple Steps”  is a guide to help minimize the damage done to the breast and nipple itself.   Prior to latching the baby, you may want to try some basic Suck Training to help widen the baby’s mouth and help the infant to latch deeper onto the breast.  Visit “Suck Training” for a visual guide on how to do this.

In the meantime, lets treat those already damaged nipples. Here are some options for you:

  1. Expressed Breast Milk on your nipples-Breastmilk is chalked full of live antibodies and built in healing properties. After a feed, rub some of this liquid gold onto your nipples and allow it to help aid in the healing.
  2. Gel Pads – Gel pads are great for cracked and bleeding nipples, but can be very soothing for just plain sore red nipples too. They are designed from the same type of medical therapy used to treat burns. Moist therapy has been proved to be more effective then dry therapy. So AVOID letting your nipples air dry. All thatis going to do is cause them to crack further. Moist therapy is the way to go. The gel pads are 90% water and can dehydrate if they are left out in the air. Wear them all day long when you are not breastfeeding, as this will help heal you faster. When you are breastfeeding, place them in the fridge to get cool, as this will make them feel even better when placed back on. Most brands last up to 7 days, but be sure to read the directions prior to applying. Some brands, such as Medela, recommend wetting the gel pad first. It is not necessary to wet the pads each time, depending on the brand, and you do not need to wipe off your nipple before feeding your baby. Some brands that I recommend are Ameda Comfort Gel or Lansinoh Soothies which are available in your local Target Store or pharmacy.
  3. Lanolin cream- Lanolin has been used for years as a healing ointment. It is recommended as more of a preventive cream vs. a healing ointment for cracked bleeding nipples. If you are cracked and bleeding, a stronger therapy is recommended. However, if you are just red and tender, then Lanolin is a great choice. However, if you are allergic to wool, or have a sensitivity when wearing wool sweaters, I would not recommend using Lanolin. Lanolin is made from wool, and if you are allergic, it is only going to exasperate already red, sore nipples. Last thing you need is your nipples to feel like they are on fire on top of everything else!

If you suspect that your nipples are beginning to look infected, or if the above treatments are not working, I would consult with your doctor/OB-GYN or Lactation Consultant. Some doctors may recommend using a triple antibiotic cream such as Neosporin, on infected nipples, but I would talk to your doctor prior to using this on your own. It is necessary to wash off the antibiotic cream prior to feeding your baby. If you have been bleeding from the nipples, it is possible for an infection to set in especially since there has been an open wound leading bacteria into the milk ducts. This could result in mastitis which will need to be treated with antibiotic therapy. If your nipples are bright red, burning, and or itching, it may be the result of thrush or a yeast infection. Treatment will be necessary for both you and the baby.

While your nipples are healing, it may be recommended to you by your lactation consultant to use a nipple shield. There are nipple shield guidelines to follow to ensure that both your breasts and milk supply are protected. There is nothing wrong with using a nipple shield temporarily, as long as you use it correctly.

The most important thing, is to get you and your baby feeding better so that breastfeeding can be a positive experience vs. a negative one. Consulting with someone who can help, can make all the difference both physically and emotionally. This should be a time to bond with your baby not one full of dread. If needed, seek the help of a trained professional to get both you and your baby back on track.

Copyright© 2012 Danielle Gauss,IBCLC,ICCE/ All Rights Reserved

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