treatment
Breastfeeding: my nipples are sore, what will help?
Breastfeeding provides the best nutrition for your baby and is also a fantastic chance to bond. But it's a relentless task with no chance for a day off, and from time to time, your nipples may get sore.
There can be a number of reasons for this, but if it's not getting any better, it's most often due to a poor latch. This is where your baby doesn't attach to the breast as well as it can, causing undue pressure on the nipples.
As a doctor and a mother of two, I know it's tough advice to hear that you should continue to breastfeed and try to get through painful feeds. But do seek help early to address any underlying issues and make it more comfortable in the future.
What can you find here?
Who can help?
It's important to know who is available to help you. Alone, it can be a daunting task to understand and correct the positioning, and this can cause an understandable amount of stress.
The midwife, health visitor, and your doctor or nurse can provide you with good information and support. They may be able to advise on local breastfeeding drop-in clinics where experts are available to see how the breastfeeding is going. There are also lactation specialists and breastfeeding organizations that can give you additional support.
What can I do at home?
Contrary to popular belief, taking a break from breastfeeding does not affect the pain in your nipple, so it’s best to continue breastfeeding. Interrupting the flow of breastfeeding can reduce your milk supply, as your brain will think that demand has dropped, which can then cause other problems.
Wear comfortable clothing and cotton breastfeeding bras without underwires and with good support. They shouldn’t be too tight, as this can add to the pain around the breasts.
Nipple shields and breast guarding devices are not advised, as they can affect how your baby latches on, further perpetuating the problem.
It sounds like an old wives’ tale, but cabbage leaves can actually be a really soothing remedy to relieve soreness after breastfeeding – a cool compress provides similar relief.
Are there any treatments I can try?
Breastmilk is known to be full of goodness and protective agents, so it causes no harm to try and put some breastmilk onto your nipples after feeding.
Gel pads provide some relief. Simple acetaminophen or ibuprofen, if tolerated, can be tried if it's particularly painful.
Modified lanolin nipple creams such as Lansinoh provide a great barrier when cracked and sore and can be used safely in breastfeeding.
When should I see my doctor?
If you've tried these methods without success and the pain persists, thrush may be the cause of your symptoms, and it's best to talk to your doctor. If they diagnose this, it's easily treated with prescriptions for both you and your baby. For example, antifungals such as miconazole gel applied directly to the nipples or nystatin drops to be taken by mouth may help.
If there's significant soreness and redness in one nipple, or an area on one of the breasts that suddenly becomes red, warm, tender, and firm, this may suggest a bacterial infection. It's best to continue breastfeeding and get in touch with your doctor if it persists for more than a day or two or if you feel unwell and feverish. They may diagnose a skin infection called cellulitis or a milk duct infection causing mastitis and offer antibiotics to help clear it.
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