Nipple Care

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Although breastfeeding is good for you and your baby, it can be hard on your nipples! Read our advice and tips on nipple care to help keep soreness at bay
Sioned Hilton, health visitor, neonatal nurse and lactation consultant:
Mum-of-three Sioned has been supporting families with babies and young children for more than 30 years. As well working with breastfeeding and expressing mothers, both in hospitals and the community, she contributes to parenting magazines and conferences, and delivers workshops for healthcare professionals.
“Breastfeeding shouldn’t hurt” is a mantra new mums often hear. But many find the reality is rather different in the early days.
For starters, during pregnancy most women’s nipples become larger and more sensitive. And when your newborn starts feeding from them he creates pressure and suction unlike anything they’ve ever experienced before (well, if you’re a first-time mum at least).
Breastfeeds can take a long time too – sometimes up to an hour – and your baby may feed up to 13 times a day.1 All this new suction, pressure and saliva can result in sore nipples.
Think about lips that get sore or cracked from the wind or sun. The more you wet them by licking them, the more dry and damaged they get – so you moisturise to soothe and protect them and to help them heal. It’s the same with your nipples.
However, soreness shouldn’t last long as you and your baby should become accustomed to breastfeeding during the first couple of weeks. Treating problems promptly is essential for preventing further damage. So if your nipples crack, start bleeding, or are excruciatingly sore, speak to a lactation consultant or breastfeeding specialist as soon as you can.2
However, prevention is better than cure – so read my troubleshooting tips below.
The key to pain-free breastfeeding is a good latch. When your baby is latching on, aim your nipple towards the roof of his mouth. This should help him latch on to the nipple, as well as some of the areola (the circle of darker skin around the nipple) beneath it. Having both the nipple and some of the breast tissue into his mouth like this will help him feed properly.3
Get your baby’s latch checked by a lactation consultant or breastfeeding specialist in the first few days. They’ll give you advice on overcoming any problems and may suggest alternative breastfeeding positions to help you feed your baby as painlessly as possible.
Tongue-tie (ankyloglossia) affects 4 to 11% of newborns.4 It means the strip of skin that attaches the tongue to the bottom of the mouth, called the lingual frenulum, is too short. A tongue-tied baby may not be able to open his mouth wide enough to take in plenty of your breast when he feeds, and his tongue probably won’t cover his lower gum while he sucks. The result can be sore nipples for you and frustration for him.
A healthcare professional, lactation consultant or breastfeeding specialist needs to assess your baby to confirm a tongue-tie. It can be treated with a simple procedure called a tongue-tie division if necessary. Carried out by a healthcare professional, this doesn’t usually require anaesthetic and may help resolve feeding problems immediately.5
There is a similar, but rarer, condition called a lip-tie, where the frenulum attaching the upper lip to the top gum is too short. Tongue-ties and lip-ties aren’t always picked up in neonatal checks, so if you think one of these could be causing your nipple pain, seek advice quickly.4
Breastfeeding nipple care tips
Only wash your breasts with water when you bath or shower. The little bumps (Montgomery glands) on your areolae produce an oil that moisturises and protects your nipples. Soaps and shower gels can strip this natural oil, causing dryness and irritation.6
Air-dry your nipples or dab them gently with a towel. Women used to be told to rub their nipples to toughen them up, but this isn’t advised any more – thank goodness!
There’s no need to clean the breast or nipples before breastfeeding. In fact, bacteria from the surface of your breast can help develop your baby’s gut microbiome.7
Fresh breast milk can help heal damaged nipples,8 so try massaging a few drops into them before and after feeds.
Change nursing pads frequently if they become damp to reduce the risk of bacterial or fungal infections, including thrush.6
Avoid increasing the gap between breastfeeds to ‘rest’ your nipples. Your baby needs to feed on demand to stay healthy and grow well. Remember, frequent feeding builds and maintains your supply, so keep feeding through any soreness.9
Useful nipple care products
Nipple cream made from ultra-pure lanolin – a natural product obtained from sheep’s wool. This moisturises and supports healing. It’s harmless for your baby, so there’s no need to wash off lanolin before breastfeeding.
Hydrogel pads can be placed on sore nipples to offer instant breastfeeding pain relief, as well as creating ideal conditions for healing. You can even keep them in the fridge for cooling comfort.
Breast shells fit inside your bra. They’re great for stopping clothing rubbing against sore nipples, and have holes in so air can still get to your nipples to help them heal.
Nursing bras made from either a breathable material like cotton, or a fabric that dries quickly and wicks excess moisture away from damaged nipples.
Nipple shields are silicone covers that fit over your nipples, with small holes for your breast milk to flow through as you breastfeed. They protect the skin underneath and can give a baby with a poor latch something firmer to attach to. In general nipple shields should be considered a short-term solution. If problems or pain occur, consult your lactation consultant or breastfeeding specialist.
Once your baby and your nipples are used to breastfeeding, it’s true it shouldn’t hurt. It’s worth reiterating that the number one cause of sore nipples is a poor latch. If one breastfeeding expert hasn’t been able to resolve your nipple pain, try another, and another if necessary.
If your nipple pain persists or you notice unusual symptoms, see a lactation consultant or breastfeeding specialist. White spots or flakiness on your nipples could be thrush, whitish or blueish nipples could be caused by a circulatory disorder such as Raynaud’s disease (vasospasm), and pus or hot redness are signs of infection.2
2 Berens P et al. Academy of Breastfeeding Medicine. ABM Clinical Protocol# 26: Persistent pain with breastfeeding. Breastfeeding Medicine. 2016;11(2):46-53.
5 O'Shea JE et al. Frenotomy for tongue‐tie in newborn infants. The Cochrane Library. 2017.
8 Mohammadzadeh A et al. The effect of breast milk and lanolin on sore nipples. Saudi medical journal. 2005;26(8):1231-1234.
9 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet, Gynecol, & Neonatal Nurs. 2012;41(1):114-121.
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Home /Women Health/Nipple Care – Complete Guide
Nipples are the most sensitive regions of the woman’s breasts. We all know about how erogenous these regions are, and the important part they play in the foreplay before sexual intercourse. However these nipples are actually provided by nature for the purpose of breastfeeding. This happens shortly after pregnancy, when the nipples begin to secrete the milk that is produced in the milk ducts within the breasts.
Babies have a natural talent to suckle at the mother’s nipples. They do so by pushing the nipples with the palate of their mouths. For some women, especially who are breastfeeding their babies for the first few times, this could be a very painful process. Babies could sometimes clamp the nipples very hard causing the nipples to become sore and cracked.
Milk let-down is a naturally occurring phenomenon during lactation. When the baby suckles at the nipples, then the milk is drawn into the baby’s mouth through them. As a result, more milk runs towards the nipple area from the milk ducts situated within the breasts. For most women, this process occurs quite normally. But if there is a problem with the milk let-down process, then the baby would need to suckle harder at the nipple in order to draw milk. This would cause pain in the nipples. Such difficulty for the baby to draw out milk could also occur if the woman has inverted nipples, i.e. nipples which point inwards.
Women who are breastfeeding for their first baby would mostly not know the correct breastfeeding technique. They may not be holding the baby properly, due to which the baby would have to press at the nipples in order to get at them. Wrong breastfeeding techniques are the prime causes of women having sore and cracked nipples. Wrong breastfeeding techniques could include not keeping a support under the baby (due to which the baby becomes uncomfortable in its position and wriggles a lot), sitting in an incorrect posture while feeding the baby, pulling the baby away from the nipple quite suddenly, etc.
Sometimes the fault is with the baby itself. There is a congenital condition known as ankyloglossia, which is commonly called as tongue-tie. Babies with this condition have tight frenulums (this is the membrane attaching the tongue to the base of the mouth). Such babies would find it very hard to suckle at the nipples as their tongue movement is highly restricted.
If you have sore and cracked nipples, then you would need to stop giving the baby that breast for feeding for a while and meet your doctor urgently. If the baby continues to feed on that breast, then the pain would also continue, eventually leading to bleeding from the baby. A bleeding nipple could be very dangerous to the baby if it is fed on it. Almost all cases of sore and cracked nipples occur when the woman is breastfeeding a baby. But if you are getting sore and cracked nipples even though you are not breastfeeding, then it could be some very serious problem with the breast, including breast cancer. You must rush to the doctor to seek medical attention.
Usually, sore nipples do not last for more than a few days. The most common cause is when the baby is not able to suckle at the mother’s breast properly. If this is not the reason and your baby latches on properly, you may be experiencing an infection called thrush. The other reasons could be blisters, nipple pain, nipple cracking, or bleeding. In such relative cases, you must seek advice of a lactation consultant or a specialized doctor, to help you with these problems.
Sore nipples caused by poor breastfeeding techniques can be easily treated by simply getting more educated on the right method to breastfeed. It is best to sit in a cross-legged position on a bed if you are finding holding the baby during breastfeeding uncomfortable. Sitting on a chair could compound the pain in the nipples. It is also advisable to keep the baby in your lap on some support. You can use a pillow on your lap and keep the baby on it. This way the baby will be comfortable and would not need to suckle hard at the nipples. Also do not encourage the baby to suckle on the same breast for a long time. Take turns with both the breasts.
Find the most comfortable breast feeding position for yourself. Change positions often. Use pillows to prop up your baby, so that tugging and pulling is less.
Breast feed your baby as often as it likes. If your baby is not left hungry for long periods, then it will not feed at the breast as vigorously. Also, always feed the baby on the less sensitive breast first.
There are other breast feeding problems, such as plugged ducts and mastitis. These can be prevented by taking good care of your nipples. However, if the problem persists, you must visit your health care practitioner.
You should also read a lot of good books and health magazines of medical advice on breast feeding problems. The more you learn about your condition, the better informed you will be, and being well informed is the first step to better health.
If you have any problems with letting down the milk properly, then do not let the baby suckle much on it without seeking medical help first. The doctor could provide some supplements in order to increase the amount of milk produced in the breasts. One such commonly prescribed supplement is the supplement containing Asparagus racemosa. There are also counselors in all maternity hospitals who could help you in learning the correct method to breastfeed the baby so that it would not need to pull hard at the nipples.
Women having inverted nipples would also need to talk to the gynecologist before the child is born.
Some preparation before the breastfeeding could be very helpful in preventing sore and cracked nipples. If the breast is too engorged, then try letting out some of the milk using a pump, or simply by squeezing by hand. This will loosen the pressure in the breast a little. Also, removing a little milk before the breastfeeding would allow the milk to flow naturally when the baby begins to suckle.
Using some creams like lanolin could reduce the pain during feeding, but you would need to ask the doctor whether they would be safe for the baby. Lanolin, which means “wool oil”, is a yellowish and waxy secretion from the sebaceous glands of woolly animals; most commonly from sheep. Lanolin is collected from the sheep’s wool when it is pressed between rollers and squeezed out.
It seems as though lanolin may increase the incidence of thrush, OR, if you have thrush (or the baby) don’t use it because it may sustain the infection. Lanolin doesn’t have anti-bacterial/fungal properties (like coconut oil) so this may be why infection occurs; mothers may not always have clean hands when applying nipple cream and bacteria could be introduced.
As for coconut oil, it is a plant based oil with antifungal, antibacterial, antimicrobial, anti-inflammatory, SPF(5), and moisturizing properties and it can be safely used on or consumed by almost anyone (allergic reactions are rare, if they do occur they are often mild).
Finally, shea butter. From the nut of the Shea Tree, found in Africa, shea butter is a highly nourishing moisturizer which can be used for a great variety of skin and hair related issues; as well as for cooking and baking. There are a number of vitamins, minerals, and other excellent compounds found in shea butter, it has an SPF of 6 and it appears to have anti-inflammatory and anti-microbial properties as well. Seeing as how it comes from a nut, some people with nut allergies may experience a minor reaction. Seems like an excellent moisturizer and prevention/treatment for stretch marks!
Pregnancy is a time when a woman’s body passes through various physical and emotional changes. The main reason for these changes is the hormonal variations associated with your pregnancy. It is a clear fact that these hormonal changes are essential for you to have a healthy and happy pregnancy. But, at the same time you have to experience some difficulties during your pregnancy period. One of the major problems that almost all women face during their pregnancy is tender nipple.
Your body will be preparing for making yourself ready for breastfeeding your baby. The related physical and hormonal changes will make remarkable changes in your nipples as well. The nipple changes may include an increase in the size and tender nipples. As you near to your delivery time, your nipples and areola will change in shape and size and you may even notice leakage of a yellowish substance known as colostrum. These are the preparations of your body to feed your little one.
Nipple care during pregnancy is very important to keep yourself comfortable. There is no need to get worried about thinking how to do nipple care while pregnant. It will be very helpful if you know some tips for nipple care during pregnancy. Here are some ideas that you can try for nipple care during pregnancy.
Wear a comfortable bra: Selecting a proper bra has great importance in nipple care during pregnancy since your breast size is increasing. Try to wear bra made of soft cotton, so that it will help alleviate your nipple pain. It is better to avoid padded bra as a part of nipple care while pregnant.
Use olive oil: Doing a short massage with olive oil is a good idea for nipple care during pregnancy. This will help retain the moisture of the skin. This will help to prevent any problems that are related to dry skin, which is very common during pregnancy.
No soap on nipples: Do not try to use soap on your nipples, as it will make the nipples dry. Excess dryness of the nipple may eventually result in cracking. Use a good moisturising cleansing lotion instead of scented soaps. This is an important point to remember for nipple care while pregnant.
Moisturising creams: If you feel dryness on your nipples, use a good moisturising cream or lotion. It will help keep your nipple moisturised. There are products available in the market that is specially made for nipple care during pregnancy.
Nipple protectors: Nipple protectors are available in market that will help you to get rid of painful nipple. This acts as a barrier between your nipple and your clothes. Nipple protectors are very helpful in nipple care during pregnancy for women with painful nipples.
Use ice pads: Tender nipple during pregnancy is a difficult condition. It is a good idea to use an ice pad on your nipple to help relax. This will alleviate the pain and will make you feel comfortable. Do this as a part of your nipple care during pregnancy.
Breast pads: It is important to give extra care to your nipples while you experience leakage. Use a good quality breast pad. Keeping your nipples dry and clean is very important to avoid any infections. Remember this point while you proceed with nipple care during pregnancy.
Make a mixture with 1 tablespoon of apple cider vinegar in a cup of water. After feeding your baby, dip a cotton ball or a clean, small piece of cloth in the solution. Wring out the excess solution and gently apply to the nipple and the areola. This mixture ensures that the nipple remains clean and destroys dangerous bacteria or yeast infections. Next, take 1 tablespoon of raw coconut oil and lightly apply it to your breast. If you live in a warm area, keep the bottle of coconut oil in the refrigerator so that it remains solid.
Saline soaks are one of the most effective home remedies for sore nipples. Make a mixture of 1 teaspoon of salt in a cup of warm water. Allow your nipples to soak in the saline solution for 10 minutes. Let your nipples dry naturally.
Another effective and soothing mixture for sore nipples can be made by mixing a few drops of tea tree oil in a glass of tepid water. Soak a piece of soft cotton cloth in the mixture and wring out the
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