Difficulties with breastfeeding - sore and cracked nipples
Breastfeeding, like parenting, is not always uncomplicated, especially in the first few weeks after birth. It can be easy to forget at this time that, like all new skills, breastfeeding can take a while to learn and become really good at.
Not all women experience sore or cracked nipples, however, if you do it may really test your desire to breastfeed. At times you will feel that it is not worth it, and that breastfeeding is just not for you. It is strongly advised that if you are experiencing difficulties with breastfeeding to seek the advice of your midwife or lactation consultant.
What causes sore or cracked nipples?
Sore and cracked nipples are generally caused because:
- your baby is not in the correct position for feeding. The baby will chew on your nipples if it doesn’t get the areola into its mouth
- you have sensitive skin
- you may have inverted nipples (this is very rare however).
What can you do about sore or cracked nipples?
- seek help from a midwife or lactation consultant. Get them to help you 'position' or 'latch' the baby to the breast correctly. Once the baby is correctly positioned the nipple will heal within 2 or 3 days
- sit comfortably to feed your baby. If one nipple is more sore than the other, start feeding from the less painful side so that your baby does not feed furiously on the sore breast. Some women find that feeding from one breast per feed (rather than both) allows them to 'rest' the nipple for a longer duration and helps with healing. Your baby may or may not think this is a good idea!
- iIf the baby does not 'latch on' to the breast well, take care to release the suction by gently sliding your finger between his or her mouth and the breast. Don't pull the baby off the breast while they are enthusiastically sucking
- try expressing a little milk first before breastfeeding. This will soften and lubricate the nipple. Do not use creams or drying agents on the nipples.
Relieving pain from sore or cracked nipples
- some women use a warm hot water bottle or wheat bag to relieve pain. Others find that they get good relief from cold packs
- go without a bra if it is more comfortable
- paracetamol is considered safe to take for the pain. You may be reluctant to take pain relief. It is wise to remember, however, that it is very difficult to establish a healthy, breast feeding pattern if you are in pain.
Inverted nipples - do inverted nipples make it hard to breastfeed?
If you are concerned that you have an inverted nipple or nipples seek advice from your doctor, midwife or lactation consultant. Don't forget that babies breast feed, not nipple feed and that it is very, very rare for women to not be able to feed because of an inverted nipple.
Thrush infection
Sore, itchy or cracked nipples may also mean you and your baby have thrush. It can affect your baby as a red nappy rash or white spots may appear inside your baby’s mouth. It is easily treated with medication from your midwife or doctor. You should continue breastfeeding.
Further information
Phone helplines and support
You can phone Healthline on freephone 0800 611 116 or the Plunketline on 0800 933 922 for advice about breastfeeding.
You can also talk to your midwife, doctor or Plunket nurse. Your midwife may be able to put you in touch with a lactation consultant if she feels it is appropriate. Other support options include La Leche League, and your local Parents Centre - see contact details for these organisations under 'Further information and support' below.
Related topics
Also see Breastfeeding - engorgement and mastitis and Expressing breast milk
Written by Anna Mickell RCpN. Reviewed by everybody, September 2008.
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