September 20, 2011

A Mother's Milk: Overcoming Sore Nipples

Umm Layth is an American mother of two, currently living in Riyadh, Kingdom of Saudi Arabia. She is a WHO/UNICEF Breastfeeding Counselor and a member of the Riyadh community breastfeeding support group, Circle of Nurturing.

Having sore nipples is never fun. It can be uncomfortable, tiresome, and if left unchecked, very painful. Unfortunately, it’s an ailment that many breastfeeding moms suffer from, even after weeks or months of pain-free nursing.

There are many reasons why a breastfeeding mother may experience soreness in the nipple area. In order to effectively remedy the problem, it’s important to identify the correct cause. You can try doing this on your own with the symptom guide below but don’t hesitate to contact your local breastfeeding counselor or La Leche League leader if you have any questions or need help.

Common Causes and Symptoms of Sore Nipples
Ineffective Latch
Soreness on one or both sides, pain and/or discomfort while nursing, baby doesn’t seem to be satisfied after feeds. Is baby in a good position to effectively suckle? Is baby trying to nurse in new positions?
Over Cleansing the Nipple Area
Dry or irritated skin at the nipple area before a feed, discomfort and/or pain while nursing. Are you washing your nipples before feeds?
Hormonal Changes
Increased sensitivity while nursing on one or both sides, soreness after a feed. Are you ovulating? Could you be pregnant? Does baby seem to suddenly dislike the taste of your milk?
Skin Irritation or Trauma to the Nipple Area
Soreness is usually on both sides, visible abrasions or irritation on the nipple and/or areola. Is baby teething? Are you using any new soaps, perfumes, or detergents? Has baby been playing with your nipple while nursing such as biting, pulling or scraping it with his teeth?
Soreness and pain that last throughout the feed, soreness and pain does not get better with improved latching, nipples itch and/or burn. Are there cracks or abrasions on the nipple area? Is your pain sudden after a period of pain-free nursing? Could you have a vaginal yeast infection? Is your baby showing symptoms of thrush (such as white patches in the mouth that can’t be scraped off, a diaper rash that doesn’t get better, excessive gassiness or fussing at the breast)?

If the cause is an ineffective latch, go back to the basics of latching and do what you can to get it right. Having a correct latch will not only make the nursing experience more comfortable for you, but it will allow your baby to get more milk out of the breast and be more satisfied, inshaAllah.

For a good latch, make sure the following things are happening:
1. Baby’s body is facing you with his face facing the breast.
2. Baby’s mouth opens wide to take the nipple and most of the areola into his mouth. When he latches, his chin should be touching the breast, both his lips should be flanged out like a fish, his cheeks should be rounded, and his nose should be close to the breast. As he feeds, you should be able to hear him swallowing and see his chin lowering and pausing as he takes in milk before he swallows.

Visit Dr. Jack Newman’s website for videos of good latching and drinking (Warning: videos contain partial nudity of breastfeeding mothers).

For dry and/or irritated skin, stop the use of any new soaps, lotions or detergents, especially those that you may have been applying to your breasts and/or nipple areas. Also, don’t worry about cleansing your nipples before a feed. Your body naturally secretes oil onto your nipple and areola area to keep the skin soft and supple for nursing. When you wash the nipples before feeding, you wash away that oil and dry out the skin unnecessarily.

For other irritations or trauma, check out these tips from on healing nipple cracks and abrasions.

If after trying these remedies, you still experience dry skin, try expressing a few drops of breastmilk and applying it onto the nipple and areola areas before feeds. Your breastmilk contains natural antibiotic properties that can provide relief, moisture, and healing to any damaged areas.

For hormonal changes, there isn’t much that you can do to remedy the situation other than ride it out. For many moms, increased sensitivity and soreness from ovulation or new pregnancies often subsides on its own. In the meantime, there are a couple of ways that you can make yourself and baby more comfortable.

1. Try nursing from the side that isn’t sore first.
2. After a feed, seek relief from the soreness by dabbing a bit of 100% lanolin cream to the nipple area after a feed. The lanolin will provide both soothing and healing for the skin of the nipple and areola. A little bit of lanolin goes a long way. 

For detailed questions about nursing during pregnancy, check out the Kellymom FAQ.

For thrush, the steps to remedy the situation will depend on how severe the infection is and whether it’s something only the mom suffers from, or both the mom and the baby. To identify which stage of thrush you may have, and for treatment options, see the Candida Protocol Sheet by Dr. Jack Newman

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