Soreness is common for many breastfeeding parents, particularly during the initial weeks after birth. While discomfort can be a concern, it is often temporary and manageable, improving as the parent and baby adjust to feeding. The primary cause of nipple trauma is usually mechanical, stemming from how the baby attaches to the breast. Understanding feeding mechanics and applying immediate soothing measures can significantly help continue the breastfeeding journey.
Immediate Relief and Comfort Measures
Between feedings, simple soothing steps help reduce inflammation and promote skin healing. Applying purified lanolin ointment after a feeding creates a moist healing environment and a protective barrier against friction. Alternatively, expressed breast milk contains natural antibodies and wound-healing properties; a few drops can be gently rubbed onto the nipple and areola before allowing the area to air dry completely.
For immediate, cooling relief, hydrogel pads can be placed over the nipples. These pads offer a soothing sensation and help prevent sticking to clothing, but they must be kept clean to avoid introducing pathogens. A warm, moist compress, such as a washcloth soaked in warm water, may also reduce pain and aid recovery. If the pain is severe, over-the-counter medication like acetaminophen or ibuprofen can safely manage discomfort, after ensuring it is safe for the parent.
Identifying and Correcting Latch Issues
The most frequent cause of nipple soreness is a shallow latch, which focuses pressure on the sensitive tip of the nipple rather than the deeper breast tissue. A deep, effective latch is characterized by the baby having a wide-open mouth, flanged-out lips, and the chin touching the breast. The baby’s mouth should cover a significant portion of the areola, allowing the nipple to rest far back near the junction of the hard and soft palate.
A shallow latch often results in a clicking or smacking sound during feeding, pain persisting beyond the initial minute of suckling, or a nipple that looks flattened or pinched after the feeding. To correct this, aim the nipple toward the baby’s nose, encouraging them to open wide and tilt their head back slightly. When removing the baby, always break the suction first by gently inserting a clean finger into the corner of the baby’s mouth.
Various positions can help facilitate a deeper, more comfortable latch, especially in the early weeks. The cross-cradle hold is effective for newborns because it allows the parent to support the baby’s head with the opposite hand, providing precise control to guide the baby onto the breast. For those recovering from a cesarean birth, the football hold (clutch hold) keeps the baby’s weight off the incision site by tucking the baby’s body under the arm.
The side-lying position is a restful option where both the parent and baby lie on their sides facing each other, with the baby’s nose aligned with the nipple. This position is beneficial for nighttime feedings or extreme fatigue, though it may require extra pillows to ensure the baby is positioned high enough for an optimal latch. Regardless of the position chosen, the baby should be brought to the breast, not the breast pushed toward the baby, and the baby’s body should be aligned “tummy-to-tummy” to prevent the head from turning.
Recognizing When to Seek Professional Help
While some initial tenderness is common, pain that causes an open wound, bleeding, or persists past seven to ten days requires consultation with a healthcare provider or an International Board Certified Lactation Consultant (IBCLC). Persistent pain suggests the underlying mechanical issue has not been resolved and is actively damaging the tissue.
Specific symptoms indicating a possible infection require immediate medical attention. Signs of mastitis, a breast tissue infection, include flu-like symptoms, fever, body aches, a painful lump, or a reddened area on the breast. A fungal infection like thrush may cause deep, burning pain in the breast that continues after feeding, often accompanied by shiny, flaky, or red nipple skin. A professional can assess for contributing factors, such as a lip or tongue tie in the baby, or the need for prescription treatments.