Sore Nipples from Breastfeeding? St. Luke's Hospital

St. Luke's Emergency Department

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What do I do for sore nipples?

  • Use a good lower areolar latch
  • Check that baby's mouth is wide open during the entire breastfeeding
  • Support your breasts while breastfeeding for the first couple of weeks (U-hold for modified cradle and C-hold for football)
  • Use different breastfeeding positions
  • Use breast massage and hand expression.  Put a little colostrum onto your nipple to soften it before latch. This also gets milk to baby quicker so less pressure/soreness to your nipples.
  • Keep baby nursing vigorously 10-15 minutes each side. Use breast massage/compression during feeding to keep baby vigorous.
  • Allow baby to nurse again if baby is still hungry. Do not allow baby to nurse for long periods of time without changing sides, as this causes sore nipples.
  • Remove and re-latch, reposition baby during feeding. (painful nsg, poor latch, sleepy baby, etc.)
  • To break the latch, insert your finger into baby's lips and between baby's gums to break the suction. Gently scoop your nipple out.
  • After nursing, use colostrum/breast milk, Lanolin or Vitamin E as directed. (see purple instruction sheet)
  • Decrease pump pressure with sore nipples.
  • Have a lactation consultant check that the pump flange is the correct size for your nipple.

Treating sore nipples

Sore nipples can occur for many reasons, from baby getting a poor latch to using the wrong size bra cup. Here are some things to try. Please note - blisters, cracking, bleeding and continued pain are not normal. Contact a lactation consultant at (319) 369-8944 for more assistance.

  • Nurse baby on the nipple that is less sore first.
  • Try different nursing positions.
  • Pump before baby latches onto your breast. This softens the area so baby gets a better latch and starts milk flowing.
  • Get a good latch by tickling your nipple on baby's lip so he/she opens mouth wide. Point your nipple up to baby's upper lip and nose so he/she has a lot of the lower areola in his/her mouth.
  • Correctly remove baby from your breast by inserting your clean finger in their mouth to break the suction. If it is still sore after one minute of nursing, try again to get a good latch.
  • Massage and squeeze your breast if baby becomes sleepy to keep him/her nursing vigorously. Stroking baby's head, chin, back or feet also helps.
  • After nursing, look at the shape of your nipple, it should be round. If the nipple is pointed or pinched please call a St. Luke's lactation consultant at (319) 369-8944.

Additional ways to help sore nipples heal

  • Apply breast milk to your nipples after nursing and let air dry before closing bra flaps.
  • Do not use soaps or lotions on your nipples.
  • Change nursing pads when wet. Do not use plastic lined pads.
  • Take over-the-counter medication for pain, like acetaminophen (Tylenol) or ibuprofen (Advil).
  • Pumping your breasts on low pressure may help your nipples heal. Feed the pumped milk to your baby.
  • Use 100 percent pure lanolin (PurLan or Lansinoh) or vitamin E capsules on nipples after you nurse. (Do not use lanolin if you are allergic to wool or sensitive to mascara.)
  • Air dry nipples 10-15 minutes after nursing.
  • Pierce vitamin E capsule and apply one drop to each nipple. (Capsule may be used until empty. Capsule should be covered after use as light reduces its effectiveness.)
  • Massage into tender areas.
  • Do not wipe off before nursing.
  • Continue treatment for 48 hours, then discontinue for 24 hours.
  • Evaluate healing and use breast milk as breast cream during this time.
  • If healed, continue to use breast milk as needed.
  • If you still need vitamin E, resume use for another 48 hours.

If you see no improvement, contact a lactation consultant at (319) 369-8944.