Dealing With Breast and Nipple Soreness When Breastfeeding

A highly rewarding experience with many health benefits for your child, breastfeeding may also come with its own set of problems for mothers, including breast and nipple soreness.
Nipple pain is generally caused by nipple trauma such as cracks, abrasions, blanching, vasospasm (blood vessel constriction) and milk blisters. The baby’s latch traumatizes the nipple, causing painful injury or a blockage of pores and preventing the flow of milk.
Breast pain problems include engorgement, plugged ducts, mastitis and thrush. Engorgement occurs when the breasts get very full and hard and sensitive. A plugged duct, in which the flow of breast milk gets blocked, may feel like a hard, tender area on one of your breasts. Plugged ducts are often a precursor to mastitis, which occurs when an infection leads to an inflammation of the breast. Mastitis can be very painful and is usually accompanied by a fever of 101.3 degrees F. According to Maureen Minchin in “Breastfeeding Matters,” mastitis occurs in 1/5 of breastfeeding women in the West.
But, there are ways to relieve each of these problems, so that you can continue feeding and bonding with your baby.

General Guidelines

Step 1

Consult with your doctor or lactation consultant to determine which condition is causing the nipple or breast soreness. The exact treatment will depend on this diagnosis. But, if you need to act fast, there are some general guidelines that should help you no matter what the cause.

Step 2

Work with your baby to improve her latch. Painful nipples and breast tissue are frequently the result of a latching technique that could benefit from refinement or latching problems needing medical attention. If you need help, see a qualified lactation consultant, who can directly assist you and your baby to nurse comfortably and effectively. (See Resources for a directory search of local lactation consultants.)

Step 3

Empty the breasts frequently. Nurse or pump as much as possible, as many breast and nipple soreness issues, including plugged ducts, mastitis and milk blisters, are the result of milk getting “stopped up.” If nursing is unbearably painful due to nipple trauma, nurse on the other breast and use a breast pump on the sore breast.

Breast Pain: Engorgement, Plugged Ducts, Mastitis

Step 1

Rest as much as possible for engorgement, plugged ducts and mastitis. Nurse often. After nursing, empty the breasts of any milk that your baby didn’t take by expressing or using a breast pump.

Step 2

Increase your intake of fluids. Encourage the flow of milk by avoiding tight bras.

Step 3

Use wet heat. Apply a cloth or diaper filled with warm water to the affected breast. Combine a hot shower and massage to help get the breast milk flowing and provide relief.

Nipple Pain: Nipple Trauma, Milk Blisters and Thrush

Step 1

Apply lanolin ointment to nipples that have experienced nipple trauma. Use only purified lanolin that has been formulated for breastfeeding mothers.

Step 2

Avoid caffeine and use dry heat on nipples in the case of vasospasm, which is the sudden, painful constricting of the blood vessels in the breasts that can occur between feedings.

Step 3

Express some breast milk after each nursing and rub it on the nipples. This is an old remedy for nipple soreness and takes advantage of the antibacterial properties of breast milk.

Step 4

Treat thrush, which spreads easily, both on the nipples and in the baby’s mouth. As thrush can be stubborn, contact your doctor for the most effective treatment. Your doctor may suggest nystatin, gentian violet or other prescription or over-the-counter treatments. According to La Leche League International, thrush treatment typically lasts at least two weeks, and your symptoms may get worse before they get better.