breast-feeding is a sign of a problem and should not
be ignored. Although sore or tender nipples are common during the first few
days of breast-feeding, it should improve. Normal soreness or pain usually
occurs for about a minute when the baby first latches on to the breast. Pain
that is severe or continuous or that occurs again after it seemed to resolve is
a sign of a problem and should be corrected. Other problems may include
cracked, bleeding, or bruised nipples.
Sometimes sore nipples
develop when the baby begins to suck harder because he or she is not getting
milk quickly. This often is caused by:
The baby sucking for comfort ("hanging out")
without a proper latch after falling asleep at the breast.
the baby's mouth away from the breast without first breaking the suction.
The baby having a short frenulum (the frenulum connects the tongue
to the bottom of the mouth). This is also called "tongue-tie."
Before and during breast-feeding
If your doctor says it is okay, take a small dose of acetaminophen (such as
Tylenol) about 30 minutes before breast-feeding.
Make sure that
your baby is latching on correctly. View a slideshow on
latching to learn how to get your baby to latch
To minimize discomfort, start breast-feeding on the side that
is less sore for the first few minutes, then switch to the other side. The
baby's initial sucking is usually the most vigorous.
little milk from your breasts right before a feeding. This can help with the
let-down reflex and soften nipples so that the baby
can easily and gently latch on.
Change your baby's position with
each feeding. This changes the pressure from the baby's mouth to a different
part of the breast.
General breast care and treatment for sore nipples
Allow some breast milk to dry on your nipples.
Breast milk contains natural skin softeners and
antibodies to fight infection, which can help heal
nipples and keep them healthy.
Let your nipples air-dry after each feeding. This prevents clothing from
sticking to and irritating the breast. Moistening the nipple helps detach stuck
Apply modified lanolin or other specially formulated
ointments or creams made with hypoallergenic ingredients (such as Lansinoh or
modified lanolin USP25).
To reduce pain, apply cool compresses to
your nipples after breast-feeding. Gel pads can also be used on dry
If your nipples are very sore, placing breast shields
inside your bra to prevent contact between clothes and nipples may help.
Use hydrogel pads to help soothe and heal sore or cracked nipples. They are worn inside your bra and help maintain the natural moisture of the skin.
Use proper breast support. Cotton bras with
wide, nonelastic straps will help support your breasts without irritating the
nipples. Breast-feeding bras open at each cup to allow breast-feeding and to
allow nipples to air-dry. If it is more comfortable, wear a bra at night for
If your nipples are very sore, ask your doctor or
lactation consultant to check your baby's tongue for a short frenulum. A short
frenulum (which connects the tongue to the bottom of the mouth) can limit the
baby's tongue movement and cause pain.
Be sure to contact your doctor or a lactation consultant if you continue to have sore, red nipples after trying home treatment for a day or two.
Breast-feeding pads that have plastic
Most general-purpose lotions and creams. These are not
recommended because their properties have an unknown effect on both your
nipples and your baby.
Washing your nipples with soap. Soap removes
the nipples' natural lubricants and will dry them out.
Cracked or bleeding nipples
If your nipples are cracked or bleeding, it's okay to continue breast-feeding your baby. To help relieve your discomfort, use the care tips given above. Call your doctor or a lactation consultant if you find it too painful to breast-feed or if you've tried home treatment for 24 hours and it doesn't help.
Watch for signs of infection, such as a fever, flu-like symptoms, or a painful area on the breast that may be reddened, warm to the touch, or both.
Call your doctor now if you have:
Increasing pain in one area of the breast.
Increasing redness in one area of the breast or red streaks extending away from an area of the breast.
Drainage of pus from the nipple or another area of the breast.
A hard area in your breast and you are not able to empty your breast.
A fever of 101°F (38.5°C) or higher.
Call your doctor today if you have:
Swollen glands (lymph nodes) in the neck or armpit.
American Academy of Pediatrics and American College of Obstetricians and Gynecologists (2012). Care of the newborn. In Guidelines for Perinatal Care, 7th ed. pp. 265–319. Elk Grove, IL: American Academy of Pediatrics.
Lawrence RM, Lawrence RA (2009). The breast and
physiology of lactation. In RK Creasy et al., eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 125–142. Philadelphia:
Pessel C, Tsai MC (2013). The normal puerperium. In AH DeCherney et al., eds., Current Diagnosis and Treatment Obstetrics and Gynecology, 11th ed., pp. 190–213. New York: McGraw-Hill.
How this information was developed to help you make better health decisions.