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Expert Q&A

	By Melissa Clark Vickers International Board Certified Lactation Consultant Moms & Babies Huntingdon, Tenn.

I have been breastfeeding for 2 weeks now & still feel some nipple soreness. Is this normal, or does it mean that the baby is not latching on properly?

First of all, breastfeeding is not supposed to hurt. Second, it is difficult to tell what is going on by email, but here are a few guidelines:

How sore is sore? Some women -- even if everything is going right with breastfeeding -- do experience some tenderness during the early days of breastfeeding. Anything more than a mild sunburned feeling should be checked out by either an International Board Certified Lactation Consultant (IBCLC) or an accredited La Leche League Leader.

Is the soreness getting better? That's a good sign. Some of the problems that can lead to sore nipples work themselves out over time as baby and mom get more proficient at breastfeeding.

Has the soreness been there all along, or did it start days after the baby began nursing? Soreness caused by poor positioning, or an unusual sucking motion by baby, typically happens from the first nursings. It is important that your baby be at breast level, facing your breast so that he doesn't have to strain or turn his head to eat. His mouth should be open wide, with a mouthful of breast, and his tongue should be cupping UNDER the breast. His chin and nose can touch the breast. Often just a minor change in positioning makes a major improvement in discomfort.

A yeast infection can also cause soreness, and often appears "out of the blue." If you or your baby has had antibiotics recently (they often destroy the "good" bacteria that normally keep yeast in check), or if you are prone to vaginal yeast infections, you might suspect yeast. Sometimes baby will have white patches inside his mouth that won't wipe off, or a diaper rash. Your nipples might be iridescent pink, and itchy. It is possible to have yeast without symptoms, however, and it is important that both you and your baby be treated if yeast is suspected.

Sometimes, soreness is a matter of chapped skin--especially during the wintertime. Using an ultrapure Lanolin such as Lansinoh for Breastfeeding Mothers after nursing can be very soothing, and doesn't have to be washed off before nursing.

I would encourage you to talk to a lactation consultant or La Leche League Leader. They can help you pinpoint exactly what is causing your soreness. And remember, breastfeeding is not supposed to hurt!"

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