Ouch! Sore nipple dilemma solved

Published Oct 16, 2000

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Unfortunately, this is a common - but solvable - introduction to breastfeeding. So hang in there!

Women typically get sore nipples in the first days of breastfeeding while they're learning how to position their babies onto their breasts.

Check your nursing position, and make sure you aren't putting your nipple into your baby's mouth at an upward angle and letting it rub against the roof of her mouth.

Although it's normal to feel some minor discomfort for the first few minutes of breastfeeding, nursing shouldn't usually hurt.

Sore nipples can also be caused by thrush, a yeast infection inside your baby's mouth that she passes to you while nursing.

Signs of nipple thrush - which can easily be cleared up with a prescription antifungal cream - include slightly reddish or pinkish nipples; puffy, dry, flaky skin; an itchy, burning feeling in your nipples; and even a deep, shooting pain after feeding.

How to avoid sore nipples?

When you offer your breast to your baby, support it with your fingers underneath and your thumb on top.

Stimulate your baby's rooting reflex by tickling her lower lip with your nipple until she turns toward it with her mouth open wide, as in a yawn.

Aim the nipple down, not up, as the baby latches on, and pull her in very close. (Baby's nose and chin should be touching the breast.)

Make sure she has a good amount of the areola - the dark area around the nipple - in her mouth; her lips should be splayed out around your breast.

If the baby attaches to the nipple only and starts "chewing," the nipple becomes sore and cracked and perhaps even bleed.

Don't hesitate to take baby off your breast as soon as you notice she's latched on incorrectly.

To break the suction, carefully slide your pinkie (make sure your fingers are clean) between breast and baby's gums.

When you hear a soft pop, indicating that suction has been broken, gently extract your finger from her mouth, move her away, and reposition her correctly onto your breast.

If you're still having trouble, or if you just want some encouragement (understandably!) that you're positioning your baby correctly, call a lactation consultant (usually the maternity hospital can refer you to one) or your pediatrician's office, which may have a breastfeeding coach or nurse-consultant.

Ease the pain

Take acetaminophen tablets (such as Tylenol) or a pain reliever prescribed by your doctor a half-hour before feeding.

Apply ice or a cold compress to the nipple just before nursing.

Begin nursing on the least sore side if there is one, since your baby will suck most vigorously initially.

Air dry nipples after each feeding and leave them exposed as much as possible between feedings.

Or wear a cotton t-shirt over a nursing bra with the flaps down.

Avoid using soap on your nipples; it dries them out.

Simply rinse them when bathing. Wash your hands before handling your breasts.

Do not apply nipple creams or lotions to your nipples; they don't promote healing.

Nurse every two to three hours to avoid engorgement, which can contribute to sore nipples. If you're engorged, express a little milk (by hand or with a pump) until they soften a bit.

Contact a trained breastfeeding consultant or other experienced person early if nipples blister, crack, bleed, or remain sore after the first few days.

Call 1-800-LA-LECHE or ask your obstetrician for the name of a lactation consultant.

Keep in mind that though the early days of breastfeeding can be very uncomfortable, it really does get easier.

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