By Kelly Burgess
Some new moms think sore nipples are an inevitable part of nursing, so they try to treat the pain with home remedies or they just put up with it and hope it goes away. According to Dr. Nancy Brent, pediatrician and board certified lactation consultant at the Breastfeeding Center of Pittsburgh, there is at least one study that has found as many as 97 percent of all nursing mothers struggled with the problem of sore nipples. That’s the bad news. The good news, Dr. Brent says, is that sore nipples not only are completely treatable—they’re completely preventable.
The key, Dr. Brent says, is knowledge of the causes of soreness and solving them before they become a serious problem. Here are the most common causes and their solutions:
The main cause of sore nipples is incorrect latching on the part of the baby, Dr. Brent says. She estimates that this is the problem in 90 percent of all cases.
“There are some other unusual causes for pain and discomfort, such as anatomical issues, but they’re very rare,” Dr. Brent says. “The one thing I tell people is that while Baby has an instinct to suck, the ability to breastfeed is not instinctual—it’s taught.”
If you feel pain when breastfeeding, do not continue and let it get worse. Rather, break the suction and try to reposition the baby for a proper latch, which is when the entire nipple is in the mouth. If you continue to have problems, contact your doctor, your hospital’s lactation consultant or your local La Leche League representative. Any of these trained professionals can help you determine the proper latch for your baby and body. If you ignore the pain, it can progress to the point where the nipple is so sore that breastfeeding is very uncomfortable. There’s no reason to let it get to that point.
Sore nipples not only are completely treatable—they’re completely preventable.
Tracy Snow of Sooke, British Columbia, suffered through the problem of sore nipples, but she couldn’t blame her babies. Snow’s twins were born six weeks prematurely, and after three weeks of pumping, her nipples were very sore.
Dr. Brent says that this is common, but, again, it can be prevented. “Women often think they have to have the pump on the highest pressure, and this isn’t necessary,” she says. “Instead, put the pump on the lowest setting that is comfortable and yet still expresses milk. That should prevent any soreness from developing.”
Snow says her soreness was helped by shorter, more frequent pumping sessions with lower suction, and it virtually disappeared once her babies began nursing. They’re now happy and healthy 10-month-olds.
The medical term for tongue-tie is ankyloglossia, and it is simply that the frenulum (the end of tissue that connects the bottom of the tongue to the floor of the mouth) is too short. This causes the movement of the tongue to be restricted, which can interfere with breastfeeding because Baby can’t get a proper latch on the nipple.
Catherine Watson Genna, a board certified lactation consultant in private practice in New York City, says that tongue tie can cause problems not only with breastfeeding, but later in life as well, contributing to jaundice, dental problems and sleep apnea. Tongue tie was traditionally identified and corrected shortly after birth, but when bottle feeding became common, physicians were no longer taught the procedure for correcting tongue tie.
Genna says that you can identify possible tongue tie by observing your baby. If he is unable to extend his tongue past his lips, it’s possible he is suffering from tongue tie.
“Some babies with tongue tie can nurse very well, usually because Mom has very elastic breasts,” Genna says. “When the mom has very firm or full breasts, tongue tie can make it difficult for them to latch properly, and that can lead to sore nipples.”
Genna also notes that even babies with tongue tie often can latch on very well the first few days of breastfeeding. It often doesn’t become a problem until the mother’s milk comes in and the breast becomes more full and firm.
If you do suspect your baby is suffering from tongue tie, you may need to shop around for a doctor who treats the condition, as not all pediatricians do so. However, the most recent research shows that correcting tongue tie in infants can prevent bigger problems down the road, in addition to solving immediate nursing issues.
A blocked or plugged duct is a lump that is painful and may even cause redness or heat on the surface of the breast. Genna says that plugged ducts can happen when the baby doesn’t drain the breast of milk, either because the baby isn’t latching well or because the mother is making too much milk. Blocked ducts can also be caused by a poorly fitted bra or a baby carrier that compresses the breast.
Home care for a blocked duct involves warm compresses and massage, but Genna says the massage must be done properly, from the front of the blocked duct toward the nipple. Don’t push on the plug from behind. Only your doctor or a breastfeeding professional can ascertain if the cause is milk production; never try to cut back on your baby’s feedings without professional guidance. If self-care does not resolve the issue, your doctor should be consulted.
Caring for Sore Nipples
While prevention is key, some nursing mothers get sore nipples precisely because they didn’t know about prevention until it was too late. In that case, here are a few suggestions from Dr. Brent on steps you can take to ease the pain of nursing while you heal:
- Nipple creams. There are over-the-counter preparations as well as prescription strength. Your doctor can tell you which you need. These are absolutely safe for your baby and do not need to be washed off before nursing.
- Breast shells. They not only protect the nipple from rubbing against clothing, but they also help the nipple cream stay on the skin.
- Tea bags. They contain lanolin, which is very soothing. Moisten them and place on nipples for a few minutes.
- Avoid soap. Soaps are drying and can exacerbate cracking. Wash once a day, in the shower, just by letting the water flow over your nipples.
- Avoid nipple shields. These are not designed for sore nipples, but rather for babies who have nipple confusion due to being given bottles. They can make the problem of sore nipples worse.
- Ibuprofen or acetaminophen. Taking these medications will help ease the pain while you heal.
While these suggestions will help get you through a bout with sore nipples, remember the best “cure” is prevention. Getting support for breastfeeding and working with someone who is knowledgeable about making sure it’s right from the very beginning will go a long way toward eliminating discomfort. This can ensure a completely pain- and trouble-free nursing relationship.