Nipple pain is normal while breastfeeding, but it can be easily relieved

You've made your way through 9 months of pregnancy and finally, you're a new parent. Congratulations!

Movies and TV shows would have you believe that the pain associated with having a baby ends with the delivery of your precious bub into your loving arms. Unfortunately, that's not the case for most breastfeeding parents, and when talking about women's health, it's important that we cover it all, from pregnancy to postpartum.

If you're experiencing sore nipples, cracked nipples or pain when breastfeeding, you're definitely not alone. In fact, one study from 2005-2007 found that 75.4% of women experience pain after their baby begins breastfeeding [1].

Although breastfeeding isn't for everyone for a variety of reasons (and naturally, we respect every mum's choice!), the World Health Organisation recommends breastfeeding exclusively for 6 months after giving birth, then continued breastfeeding combined with solid foods for 1 year and beyond, if both mum and baby wish [2].

That's a long time to be dealing with sore or cracked nipples, and no one needs that. In this article, we'll break down what's normal, what's not, and offer tips on how to soothe sore nipples.

Is it normal to experience nipple pain when breastfeeding?

The short answer is yes, it's pretty common to experience nipple soreness while breastfeeding.

While nipple pain and having trouble breastfeeding aren't as widely represented in conversations about pregnancy and postpartum as, say, labour pain, breast pain is very real, and very common.

One 2010 study found that 96% of new mothers begin breastfeeding their babies after birth, and a different study found that 75.4% of women have experienced breastfeeding pain, especially in the first few weeks after birth [3][4].

Of course, sore nipples can be caused by a number of different issues, and that will mean different kinds of pain. This can result in cracked skin, bruising, breast fullness, nipple sensitivity, even shooting pains.

Luckily, with the right care, most of these problems can be resolved.

What causes nipple pain during breastfeeding?

Most problems with breastfeeding arise in the first few weeks, while both mother and child are doing their best to figure everything out. And that's a whole process in itself!

In order to continue breastfeeding without pain, it's important to first identify what's causing the pain.

These are the most common causes of breast and nipple soreness while breastfeeding.

Latching issues

If you're dealing with nipple soreness, bleeding nipples, cracking or bruising, you may be experiencing issues with the way the baby's mouth latches to the breast.

In a good latch, your baby's mouth should be wide and taking in a large portion of your areola into their mouth. Their chin should be against your breast with their nose turned upwards.

Your nipple will be gently pressed against the roof of their mouth with their tongue cupping underneath. Once your milk starts flowing, your baby should be taking slow sucks with some pauses for swallowing.

A poor or shallow latch, on the other hand, is when the baby's mouth is positioned on the nipple rather than the breast. This can cause your baby to squash your nipple as they feed, leading to pinched and painful nipples and even a restricted flow of milk.

A short or restricted frenulum, aka tongue tie, can also prevent your baby's tongue from achieving the proper latch and will cause the baby to break the suction frequently [5].

Tongue tie affects up to 11% of newborn babies [6]. If you suspect that it is affecting your baby's latch, consult your lactation consultant or doctor.

Flat or squashed nipples

Incorrect and uncomfortable nursing positions can lead to squashing the nipple as they feed, resulting in flat nipples. This can be damaging and restrict milk flow, which can lead to clogged milk ducts and mastitis.

Clogged milk ducts

If you have a painful lump in your breast, you may be experiencing a clogged milk duct, which is a build-up of breast milk that hasn't been able to empty from the breast properly.

Telltale signs of a clogged milk duct include: a lump specific to one area of the breast, a white mark, milk blister or plug on your nipple, thickened milk, and sore breasts while breastfeeding or using a breast pump.

A blocked nipple pore can be caused by missed feedings, tight bras, restrictive clothing, and latch issues. When your baby prefers one breast more than the other, the less frequently used breast may also become blocked.

Mastitis

Affecting about 10-20% of new mothers usually within the first 6-12 weeks, mastitis is usually caused by a breast infection of the milk ducts [7][8].

If you suspect that you might have mastitis, it's time to seek medical advice, as you might need antibiotics.

The common signs of mastitis include swelling, redness, pain, itching, underarm pain, fever, flu-like symptoms, and/or a small cut or wound in the nipple or on the breast tissue.

Breast engorgement

In the first few days after giving birth, your body will rapidly increase its milk supply. As engorged breasts can come on quite suddenly, your breasts may feel swollen, heavy and hard, which can cause pain.

This pain is likely to feel like tenderness and increased sensitivity, which can reach beyond the breast and into the chest and armpits.

After the initial increase, engorgement might rear its ugly head if you miss a feed, or if you're dealing with oversupply.

Milk letdown

Milk letdown refers to the process that releases the milk from your breasts [9]. When your baby attaches to your breast, the nerves in your nipple cause hormones to be released into your bloodstream.

Some women don't feel anything when their milk lets down but other women experience a wide variety of sensations, including:

• Tingling
• Burning
• Warmth
• Pressure
• Pins and needles

Nipple blanching and vasospasm

Nipple blanching refers to white, painful nipples that are usually caused by a sensation known as nipple vasospasm. Nipple vasospasm is when the blood vessels supplying blood to your nipple spasm during or immediately after breastfeeding [10].

It generally happens if your baby isn't latching to your breast properly. In a shallow latch, the pressure of your baby's mouth against your nipple can prevent the blood from flowing to the area.

Usually, nipple vasospasm is worse when you're feeling cold or if you have a history of Raynaud's phenomenon.

To prevent nipple vasospasm and blanching, you should avoid exposing your nipples to cold air and keep your breasts warm by using breast pads, warm clothing or a heat pack after breastfeeding.

Teething

Breastfeeding can come with some literal teething issues and unfortunately, it's your nipples that catch the brunt of it. When your baby begins to teethe, the increased saliva and enzymes in their mouth can irritate your nipples.

The best way to prevent sore nipples when your baby is teething is to rinse the baby's saliva off your nipples immediately after breastfeeding.

Pain from pumping equipment

Breast pumps can take some getting used to and if you're experiencing nipple pain while using pumping equipment, you might not be using it correctly [11]. If there's too much suction from the breast pump, you can injure the top of your nipple and restrict your milk supply.

The wrong size breast pump flange can also irritate your nipple and areola.

Dry skin

If your baby has a strong or aggressive suckle then your nipples might become sore, chapped and dry. Dry nipples are more prone to cracks, which can then lead to further infections and pain.

Thrush

If your nipples are flaky, shiny, or red, you may be dealing with thrush, a yeast infection. Another sign that points to thrush is deep breast pain, rather than just sore nipples.

If you think you may have a breast infection, it's important to speak to your doctor or lactation consultant, as you may need an oral or topical medication to treat it.

It's worth taking quick action too, because if the mother's breasts have thrush, then it's likely your baby will have it too. For your bub, thrush can be spotted via little white marks on the tongue, insides of the cheeks, or red and/or cracked lips.

Is it safe to breastfeed with sore nipples?

Yes, in fact, it's recommended in most cases.

With the proper care, you should be able to treat sore nipples, but any cracking, bleeding or bruising won't be harmful to either you or the baby.

If you've tried at-home treatments with no signs of improvement, or have signs of infection, contact your doctor or lactation consultant.

How to prevent nipples hurting when breastfeeding

Nipple pain can make breastfeeding very uncomfortable but there are a few ways to prevent and reduce nipple pain to ensure that you have a more comfortable and enjoyable breastfeeding experience.

Preparing your breasts and nipples for a feed can help you feel more relaxed and reduce any nipple pain that you're experiencing.

Before a feed, you can try:

• Taking a warm shower or using a warm washcloth on your breasts

• Giving your breasts a gentle massage to stimulate your milk flow

• Help yourself feel relaxed by doing some deep breathing or listening to music

• Expressing a little milk to lubricate the nipple

• Offer a feed before your baby gets too hungry to reduce the intensity of their suckle

During the feed, you can also try:

• Starting the feed on the less sore side

• Checking the baby is properly latched to your breast

• Avoiding any nipple pinching by pulling the baby in closer, leaning back and checking the baby is positioned in a straight line

• Trying different breastfeeding positions

• Giving the affected breast a 12 to 24-hour break and express your milk instead

• Using a nipple shield, which is a silicone device you place over your own nipple to help your baby latch and protect your nipple. They can decrease the amount of milk transferred between mum's nipples and the baby, and could lead to a milk blister or mastitis, so it's best to speak to a lactation consultant about whether a nipple shield is right for you.

Tips for treating sore and cracked nipples during breastfeeding

Although sore nipples can be a pain — literally — the good news is that there are plenty of ways to relieve and prevent nipple pain, soreness, cracks and bleeding nipples.

Look after the skin around your breasts and nipples

A good way to prevent sore nipples is to look after the skin around your breasts and nipples, even before the baby arrives. Using a nipple balm before the birth will help ease your nipples' transition into breastfeeding.

Rinse your nipples after feeding and let them air dry

Once dry, apply a moisturiser or nipple balm. Do not use a hairdryer to dry nipples, as this can further dehydrate skin and lead to more cracking. It's important to air dry only.

Use a nipple balm to soothe and moisturise the area

Gently pat a small pea-sized portion of nipple balm onto each nipple to promote healing and prevent future cracking.

Kin's own Nipple Cream uses an Australian-made formula of all-natural ingredients designed to nourish and restore nipples. With avocado oil, lanolin and shea butter, it works to build skin elasticity and prevent chafing and cracking.

It's also breastfeeding safe, so there's no need to wipe it off before baby latches on.

Try using gel pads

When your nipples are damaged, gel pads can be an absolute lifesaver. Cooling silicone on one side, fabric on the other to prevent friction against your clothing, apply the gel pad to the nipple in between feeds to promote healing.

Wear breast pads in between feeds

When your nipples are extra sensitive and chafed, it's a good idea to wear breast shields in between feeds. Breast shields are also great for preventing nursing breasts from leaking through your shirt, which is always good!

Nursing pads will absorb any leakage quickly, which reduces the chance of developing thrush, but make sure to swap them out and keep your nipples and breasts dry.

Kin's sustainable breast pads are made from super soft bamboo which wicks moisture, and is thermo-regulated, breathable, naturally hypoallergenic and antibacterial to reduce the risk of infections such as mastitis.

The triple-later design absorbs your milk and protects from leaking through your clothes, ensuring you feel confident no matter where you go.

They’re so comfy and seamless that you’ll forget you’re wearing them but will be glad they’re there. You’ll also have less laundry to do for leaked-on clothes, yay!

Try a hand expression or a breast pump

If you need a break from breastfeeding to give your breasts a chance to heal, try using a breast pump or hand expression to avoid oversupply and relieve breast engorgement.

Make sure to be gentle, though. Too much pressure can cause bleeding from the delicate blood vessels near the nipple.

Massage your breasts

Giving your breasts a massage can help prevent sore nipples, clogged milk ducts and mastitis. Massaging can also help clear milk blisters.

It's kind of amazing and very easy to do at home.

Starting at the outside of the breast and working your way in, gently rub toward the nipple, applying gentle pressure with your fingers. To clear a duct, try massaging in a bowl of warm water, shower or bath, or use a breast massager that's specifically designed to work with hot or cold therapy.

Try a new position

Sometimes, it's all about switching up breastfeeding positions until you find one that works for you and your baby.

The right position helps your baby's mouth to latch correctly and get the breast milk flowing. Once latched, breastfeeding will likely be far less painful.

Here are some things to try:

• Try lying back or lying on your side. This will also help prevent back pain caused by hunching forward to breastfeed.
• Use pillows for extra support. Both for you and the baby, ensuring baby's head is fully supported.
• Try different holds and switch up breastfeeding positions in order to fully drain every part of the breast. This will help prevent clogged ducts and mastitis.
• Break the suction and reposition the baby's mouth. Try to reposition the baby's lower lip away from the nipple, closer to the bottom of the areola.
• Gently pull the breast tissue back. If you have flat or inverted nipples, try lifting the nipple so that your baby can get a better latch.
• Let the baby lead the way. The Australian Breastfeeding Association reports that baby-led attachment helps bub to attach deeply, and once the baby latches correctly, breastfeeding will hurt less, even with damaged nipples [12].

Additionally, you can try:

• Relieving breast engorgement with warm or cool cloths. Apply a warm washcloth before nursing, to help with letdown and increase flow. After nursing, apply cool compresses to the breasts to relieve pain and reduce swelling.
• Avoiding tight-fitting bras. Tight clothes and bras can restrict the flow of breast milk, which can cause a number of problems. Milk ducts can become blocked, which can lead to pain and mastitis, and when you have breast milk leakage, it can create an environment of moist heat, which can cause thrush.
• Using over-the-counter pain relief. Speak to your doctor or lactation consultant about which medications you can use to ease pain while breastfeeding.

When breastfeeding support is required

While many breastfeeding issues can be resolved with simple at-home remedies, some nipple and breast pain requires medical attention, particularly if you suspect you have mastitis or thrush.

Mastitis symptoms include:

• Swelling
• Redness
• Pain
• Itching
• Underarm pain
• Fever
• Flu-like symptoms
• A small cut or wound in the nipple or on the breast.

Thrush symptoms include:

• Flaky, shiny, or red nipples
• Deep breast pain.

At Kin, we know the challenges of breastfeeding, so we've developed some handy products to help make the transition into motherhood easier. Check out our postpartum collection for all your Breastfeeding Essentials, including breast pads and nipple balm.