Managing Nipple Concerns

Nursing can be rewarding, but it isn’t always easy. Issues with nipples may make you want to give up. But, you can help prevent these types of problems:

Sore Nipples

Sore nipples are probably the most common difficulty mothers have when breastfeeding. Sore nipples may be caused by different factors. Determining the cause of sore nipples dictates the appropriate treatment. A certified lactation consultant will be able to help and suggest intervention.

Breastfeeding should not hurt, and the skin on your nipple should not break down any more than the skin anywhere on your body should break down. However, mild tenderness, similar to the kind of tenderness some women experience with their menstrual cycles, is fairly common for the first week or two of breastfeeding. Then it should go away.

If your nipples feel painfully sore or the nipples or areola feel bruised, it is more likely that it is related to an improper latch-on process or ineffective sucking. Suspect a difficulty with baby’s latch or sucking if your nipples become very red, raw, blistered, or cracked. A latch or sucking difficulty or a structural variation in the baby’s mouth might result in nipples that look creased or blanched (turn white) at the end of feedings. Certain creams or dressings may promote healing, but others can actually cause more damage. Also, avoid any treatment that might result in drying the nipple tissue, which may lead to cracking of the skin.

When nipples become red and burn, or feel extremely sore after weeks or months of pain-free breastfeeding, it may be due to a yeast infection such as thrush. Yeast may appear as white patches in your baby’s mouth or it may show up as a bright red diaper rash. Specific medications are needed to treat yeast infections. Contact your baby’s pediatrician for more information and treatment.

Flat or Inverted Nipples

Your baby can effectively breastfeed even if your nipples appear to be flattened, although it may take some time to figure out how to draw the nipple into the mouth with latch-on. Although the benefit of using hard plastic breast shells is not conclusive, you might find it helps to wear them in your bra between feedings. Breast shells exert a small amount of traction to help draw the nipple outward. Using a breast pump to draw the nipple out just prior to breastfeeding may also help.

If nipples invert, or “dent” inward, with stimulation, try the interventions mentioned for flat nipples. Nipple eversion devices are available. Ask a certified lactation consultant for information. Occasionally, a mother has one or more severely inverted nipples. If one breast is less affected, your baby can breastfeed on only one breast. Most women can produce enough milk in one breast to exclusively breastfeed their babies.

Online Medical Reviewer: McDonough, Brian MD

Date Last Reviewed: 4/6/2010

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