Sore and Cracked Nipples

Sore and cracked nipples from breastfeeding are usually caused by incorrect positioning of the baby at the breast.

To improve how your baby is attached, you may want to follow the following steps:

• When bringing your baby to the breast, support their neck and shoulder with spread-out fingers and thumb. This helps raise their chin off their chest so they can open their mouth wide and keep their nose clear for breathing. 
• Tickle your baby's lower lip with the nipple or a finger and wait for them to open their mouth wide with their tongue forward. 
• Bring your baby onto the breast, their chin and lower jaw touching the breast first.
• Your baby's lips should be flared (turned outward), covering more of the areola with the bottom lip than with the top lip.
• Your baby's head should be tilted slightly back, nor pushed into the breast. Your baby should be able to have eye contact with you.
• When your baby is getting milk, the sucking-swallowing pattern is: mouth open wide, then a pause as the baby gets a mouthful of milk, then the mouth closes. The longer the pause with the mouth open, the more milk the baby is getting. You can also see their ears wiggle as their jaw moves. 

To help heal sore and cracked nipples:

• express a few drops of breastmilk, gently massage it on the nipples, and allow to dry.
• leave them uncovered or loosely covered between feeds to help them heal
• avoid using soap on them

Pain may be helped by taking paracetamol as directed on the packet; prolonged (for more than a couple of days) or excessive use may be harmful. See your health professional if pain continues.

Other Causes of Sore Nipples:

• Pain may also be caused by blocked ducts or nipple and breast infections.
• Thrush infections can also cause sore nipples. Thrush pain usually occurs throughout and even after the feed; it can feel like a burning pain.
• Some women experience pain after the feed caused by a spasm of blood vessels. It is often a burning pain and the nipple looks white, then a throbbing pain occurs as the nipple turns back to its normal color. (This may be a condition called Raynaud's disease.)

If you cannot improve your baby's position, and your nipples are not healing or continue to be painful, get help from your midwife or other well child health provider. 

Source: Plunket, New Zealand