If you experience some nipple soreness in the first few weeks of breastfeeding, you’re not alone. It’s common for women to experience some nipple discomfort in the early stages of breastfeeding, but that initial tenderness typically goes away before long.
If it doesn’t, there may be another underlying cause, and you'll want to reach out to your healthcare provider or lactation consultant for advice.
Read on to learn more about what can cause nipple soreness, whether or not you should breastfeed with sore nipples, and how to relieve the pain.
What Can Cause Nipple Soreness When Breastfeeding?
Here are some common causes of nipple soreness if you're breastfeeding:
Your nipples are adjusting. It's not unusual for you to have nipple soreness during the first few weeks of breastfeeding as your breasts and nipples become accustomed to the process of nursing. However, the discomfort should subside once you and your baby have established a good feeding routine.
Improper latch. If your baby isn't properly latched on to your nipple during breastfeeding, it could cause soreness because of friction on your nipple as your baby's mouth chafes against the skin.
Milk blister. This is a painful white spot on or around the nipple. It consists of thickened milk or some skin that's overgrown a milk duct and blocked it, which causes the milk blister.
Blister. Unlike a milk blister, a blister from friction can be caused by something like improper latch, a poor-fitting nipple shield, or a breast pump that rubs against your skin.
Tongue-tie. If your baby's tongue cannot reach past his lower lip when he cries or if his tongue looks heart-shaped, it could be because the frenulum (tongue-tie) is short. A short or restricted frenulum prevents a proper latch, which in turn can cause nipple soreness.
Flat or inverted nipples. If you do a “pinch” test on your nipple by compressing the areola (the dark area around your nipple) about an inch behind your nipple, and the nipple doesn't slightly harden and become erect, then you might have what's considered a flat nipple. If you perform the “pinch” test and your nipple retracts, then it's considered to be inverted. Both flat and inverted nipples can prevent a proper latch during breastfeeding, which can lead to nipple soreness.
Not breaking the suction before removing your baby from your breast. Not only can this be painful, but it can damage breast tissue and your nipple.
Bras that are too tight. This puts pressure on your nipple and can irritate it.
Soaps or perfumes. These can dry your nipples and cause irritation and soreness. Laundry detergent can also cause this.
Vasospasm. After a breastfeeding session, some women may experience pain that extends from the nipple into the breast. This may be due to constriction of the blood vessels — called vasospasm — in the breast.
Mastitis. This breast infection can happen when a blocked milk duct prevents the milk from properly getting out of your breast. The milk builds up, causing pain and swelling in your breast and nipple. Other symptoms include red streaks on your breasts, flu-like symptoms like fever and body aches, and a hard lump in the breast.
Thrush infection. This is a contagious yeast infection that can infect your nipples, causing nipple soreness. If you notice white or yellowish patches anywhere in your baby's mouth or on his lips, or if he has cracked skin at the corners of his mouth, then he may have thrush. The symptoms of thrush you may notice on yourself include cracked nipples, shooting pains in your breast during or after breastfeeding, itchy or burning nipples, and unusually red nipples that are shiny or flaky.
Should You Breastfeed With Sore Nipples?
Unless your healthcare provider advises against it, try to stick to your regular breastfeeding schedule as much as possible, even if you are struggling with sore nipples. Slowing down or stopping breastfeeding could reduce your milk production.
If it’s less irritating to your nipples, an alternative option is to use a breast pump until the nipple soreness subsides.
Even if you have a breast infection like mastitis, you should continue breastfeeding. In fact, in the case of mastitis, the breast pain and related nipple soreness could worsen if you stop breastfeeding or pumping.
Likewise, in the case of thrush, it's best to continue breastfeeding unless your healthcare provider advises otherwise.
How Can You Relieve Nipple Soreness?
Relieving nipple pain really depends on resolving the underlying cause. Always follow your healthcare provider’s advice, but in the meantime you might like to try some of these strategies to help provide some relief:
Make sure your baby is latching properly. The nipple should be positioned deep into your baby’s mouth. As you nurse, your baby’s lower lip should be fanned outward over the nipple rather than being tucked in. If you gently pull down the corner of his mouth while he’s feeding, you should be able to see the bottom side of his tongue, and it should be cupping the breast.
Try different breastfeeding positions. This might help prevent friction from your baby’s mouth on the same areas on your nipples.
Properly break suction when you need to stop breastfeeding. Instead of pulling your baby away, put your clean finger into the side of your baby’s mouth to break the suction.
Leave some milk or colostrum on your nipples and let it air-dry. However, if you find that your breast milk leaks between feedings, use bra pads and make sure to change them often.
Keep soaps away from your nipples. Water is all you need to wash your nipples. Also, be sure to fully rinse laundry detergents from your bras or shirts that might come into contact with your nipples in case this is causing the irritation.
Use purified lanolin or gel pads. If your nipples are dry or cracked, applying purified lanolin after each feeding may help. Gel pads might also help soothe sore nipples.
Apply heat. Applying a heating pad, warming gel pads, or a wet, warm washcloth after breastfeeding can help reduce the discomfort.
Use breast shields. Breast shields are dome-shaped covers that help prevent clothing or your bra from rubbing against your nipples and irritating them.
Treat any infections. If your healthcare provider diagnoses an infection like thrush or mastitis, she may prescribe antibiotics or an antifungal treatment.
Ask for professional help. Don’t hesitate to connect with a lactation professional or your healthcare provider for advice on breastfeeding, and contact your provider if your nipple soreness lasts more than a couple of days or progressively worsens.