Painful and cracked nipples are not a normal part of breastfeeding. Nipples become damaged and sore if a baby is not positioned and attached effectively. If feeding is painful and/or if at the end of a breastfeed the nipple seems flattened or pinched, then the position that the baby is held in and/or the attachment needs to be adjusted and improved – please see steps to improve the breastfeeding latch.
Ineffective positioning and attachment will not only cause painful feeding, but will also result in the baby not taking enough breast milk, which in turn will result in a baby who is not gaining adequate weight, and is unsettled. In addition, feeds can take longer and the mother will become at risk of developing engorgement, blocked ducts and mastitis.
Whilst poor positioning and attachment are the cause of the majority of sore nipples, it is possible that thrush may be the cause, especially if the pain starts after a period of trouble-free feeding. A symptom of thrush is pain that continues after the feed has ended – please see information on thrush.
How can sore nipples be prevented?
Making sure that the baby is attached effectively will mean that the nipple reaches the rear of the mouth close to the soft palate. At this point it is protected from being squashed and rubbed by the tongue during the feed
Treating sore and cracked nipples involves removing the cause by improving the positioning and/or attachment. Often this will require help from a health professional such as a qualified lactation consultant. Even very sore nipples can feel comfortable during feeding once the attachment is improved.
Many creams and sprays are available, however care should be taken – they will not work unless the cause is treated.
Please get help from a qualified lactation consultant. Often all it takes is one visit to improve the latch and set you on your way to breastfeeding with confidence.