Cracked or sore nipples are a common problem among breasfeeding mothers. They can occur in one or both breasts resulting in pain and discomfort while nursing. Some of the common causes of sore nipples include:

  • Breastfeeding attachment/latching

When the baby doesn't attach the mouth to the nipple and areola properly, it can irritate the nipples and cause cracks, bleeding or pain. For a good latch, ensure the baby's head, neck and spine are linear and not twisted. Also check that the chin is up and not dropped. Make sure, also, that you are not straining with the position. You can use nursing pillows for a comfortable posture.

  • Breast /nipple problems

Having engorged breasts, that is, breasts that are full and tight can cause nipple stretching and cracking. It can also make it difficult for the baby to latch properly, hence cause irritation. Other problems that can cause sores or cracks can include nipple edema or flat or inverted nipples. It is recommendable to breastfeed or pump regularly to reduce excess milk.

  • Skin conditions

Women with eczema or dry skin may also experience sore nipples when breastfeeding. Eczema causes the skin to dry and become chapped which can make it painful and uncomfortable for nursing. Allergic reactions to chemicals in lotions, perfumes or soaps can also cause sore nipples.

  • Incorrect breast pumping 

Setting the pump suction too high or flanges that do not fit well can damage the nipples resulting in cracks and sores. Ensure to use the breast pumps as indicated to avoid nipples sores

  • Friction

Sore nipples can also occur from the nipple breast brushing against clothes or the cold weather.


How to care for sore /cracked nipples

1. Apply a cold pack or a warm compress to the sore area before nursing to relief the pain.

2. Pump milk before breasfeeding when engorged. This allows for easier latching and prevents further irritation.

3. For flat/inverted nipples, apply gentle pressure around the base of the nipple for the baby to grasp while breastfeeding.

4. Wear a breast shell to create space between the breast and pad, relieving the pressure and pain

5. Gently pat a small, pea-sized amount of lanolin cream (a fat made from sheep's wool) onto the injured nipple using clean fingertips. Lanolin doesn't need to be removed before you breastfeed your baby.

6. Keep clean. Change nursing pads and wash hands before touching cracked nipples to prevent infections.

7. Pay attention to your nursing bras. Ensure they are comfortable, are made from natural fabrics and fit well to avoid any irritations.

8. Take painkillers such as ibuprofen that are safe for breasfeeding mothers, about 30 minutes before nursing to reduce pain.

Generally, a sore nipple is manageable and will resolve itself. However, you should see a doctor if the pain radiates to the breast, if the nipples remove a bloody discharge after 24 hours, if you notice inflammation, or fever, or if the pain interferes with breastfeeding. Note that it is safe to continue breastfeeding when nipples are cracked or bleeding unless in the case of Hepatitis C or parasite infections like Toxoplasmosis. Otherwise, the blood does not harm the baby.

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