Sore Nipples - Understanding Pain as a Call to Action
Pain is among the most important signals our body gives us to help us to survive.
Regarding breastfeeding, pain helps moms to know that something is hurting her nipples and when her nipples are in pain, the ability to effectively breastfeed her baby is also threatened.
It is very uncomfortable to even hold a baby in your arms or on your shoulder when you have sore nipples, let alone think about putting baby back on the breast.
From: Beaumont Health - pain management services.
'Pain (like the pain of sore nipples), signals an injury or illness.
Pain is the body's way of telling you something isn't right. This is the purpose of pain. It is meant to make you uncomfortable so that you will know that you need to do something (or stop doing something).
When you do something that hurts your body, your brain normally triggers the pain response. If you touch something hot, the pain you feel is your body's way of telling you that you should stop touching the hot item and should take action to cool the skin.
If you walk on an injured ankle and it hurts, that's also your body telling you to stop'.
If you are experiencing nipple pain, that pain is a call to action, a call to change something so that you can heal and continue nursing in comfort.
It makes sense, that lactating mothers avoid anything that may cause sore nipples, anything that threatens their ability to breastfeed.
Please know that sore nipple pain will resolve with natural breastfeeding techniques, once the 'culprit' that caused the soreness has been identified and stopped.
Nipple Function and Care
Nipples are created to comfortably extend and retract so baby can feed effectively, and mom's nipples will stay healthy.
When nursing, the nipple extends to the back of baby's mouth, past the gums, so that when baby compresses his gums, they close on the breast, not the nipple.
Baby's tongue draws the nipple into his mouth, past his gums, then presses the nipple up to the roof of his mouth. The baby's tongue actions and sucking draw out the milk.
The lactating breast is like a factory that operates 24/7, producing the healthiest food possible for baby and delivering it through milk ducts that end at the nipple.
Natural breastfeeding allows the breast - nipple area to dry between feedings.
One does not have to think about this, it naturally happens when baby is done eating and comes off the breast.
Special areola glands keep the nipples and areolae supple and healthy.
Caring for lactating nipples and breasts is basic;
-let clean water run over the breasts in the shower
-avoid products and techniques that interfere with what nature provides
It makes sense that nature's way is always best at perpetuating the human species, with a feeding system that nourishes babies and that will keep their mothers healthy, so that moms can care for their babies.
See enticing marketing of baby feeding products for what they are; a product that is not needed to effectively breastfeed your baby.
Many nipple and breast problems happen when products are used.
Understanding the effects of using these products, may help explain why natural breastfeeding techniques are best.
Having nipples sit in moisture for extended periods of time, as when gel packs are used in the bra, cling wrap covers the breast in the bra, milk collectors are kept in the bra for hours, damp breast pads sit against the skin for very long, is NOT natural.
All these products keep the nipples in a moist environment. This differs from nature's system which allows the nipples to dry out between feedings.
Think about what happens when your hands have been in water for a long time.
The effect is drying. The same happens to nipples when they are kept in moisture for extended periods.
Nipples are built to stay healthy, let's not inhibit their ability to function.
Causes of Sore Nipples - Healing Sore Nipples
1. Improper Positioning
When using a breastfeeding 'Position that Hinders', an HSH position, baby's mouth often closes on the nipple, causing nipple pain.
Mothers using HSH (hand supporting the head or neck) positions;
the Cross Cradle Hold, Football Hold or Log Hold, often complain of nipple soreness. We do not recommend using these positions.
The repeated pulling on and off from the breast by the baby can cause nipple soreness.
Tissue damage can occur when mother is lifting baby's head to her breast and baby doesn't open his mouth wide enough. Then he may clamp down on just the nipple.
Trying to keep the baby's mouth open wide enough and for long enough when latching is difficult in the HSH holds because the hand on the back of the head is stimulating baby to push back toward the hand, thus causing the baby to close his mouth and turn away from the nipple.
(This is the Tonic Labyrinthine Reflex.)
Mothers report feeling their baby was refusing to nurse or was having a 'latch on problem' when using an HSH position.
In the Cradle Hold position, baby is an active partner in latching on. From mother's arm, baby helps by reaching his head towards the nipple, properly flanging out his lips (not curling them in).
Mother doesn't have to guess when his mouth is opened properly, he will keep it open because the only thing stimulating him is the nipple on his lips. He is not being distracted by a hand on the back of his head.
For information on 'Positions that Help' see
For information on the problems caused by the Cross Cradle Hold, Football Hold, Log Hold and Laid Back Nursing positions see
2. Ineffective Latch On
BABY NEEDS TO TAKE IN ALL OF THE NIPPLE AND SOME OR ALL OF THE AREOLA WHEN LATCHING.
Remember that the baby needs to take in all the nipple and some of the areola, the darker skin around the nipple, for an effective latch.
If baby latches onto the nipple only, it will hurt!
Mother and baby should always be tummy to tummy when nursing.
Keeping baby close helps baby to get a deep latch.
Sore and cracked nipples may allow bacteria into the breast which may lead to a breast infection, to mastitis.
For information on achieving an effective latch see
3. Thrush, other Fungal Infections, Skin Issues
Thrush may present as white spots inside baby's mouth.
If Mom's nipples itch, crack, burn, are pink or skin is flakey, or if there are shooting pains between feedings, it may be a fungal infection called thrush. Mom may also have a vaginal yeast infection, and Dad may need treating, too.
All people have a certain amount of yeast in their system, thrush is an overabundance of yeast.
Both mom and baby (and Dad), need to be treated simultaneously, so they are not passing thrush back and forth to each other when nursing.
Medical treatment and a balanced diet with probiotics help to heal thrush, which will then heal the sore nipples.
-Bacterial infections of the nipple - see medical personnel.
-Dermatitis (skin infection) around the nipple - see medical personnel.
-Nipple Eczema - see medical personnel.
4. Products that may contribute to sore nipples.
-Nipple creams may harbor bacteria.
-Nipple shields and breast pumps may cause soreness.
-Damp breast pads.
-Cling wrap and gel packs.
-Artificial nipples - bottle nipples, pacifiers, nipple shields.
For information on how products can cause breastfeeding issues see
5. Nipple Trauma
-Always break the suction before taking baby off the breast.
Place your finger in the corner of his mouth before taking him off, to
prevent injury. A baby's suck is very strong!
-Avoid injury during pumping by trying to simulate how baby sucks with the pump, not how to get the milk pumped as quickly as possible.
-Avoid artificial nipples the first 6 weeks so that baby learns to suck effectively and not chew on mom as he can do on a bottle nipple.
Once baby has learned to breastfeed using natural techniques, and is about
6 weeks old, they often can go between breast and bottle without difficulties.
-Be especially gentle when bathing, no soap is needed on the breasts, just water. Be gentle with wash cloths.
6. Blebs - Milk Blisters
A Bleb or Milk Blister is a white, painful dot on the nipple or areola.
You can treat it as you would mastitis.
-Make sure you are using the Cradle Hold or Lap Nursing Hold or
Lying Down breastfeeding positions.
-Make sure your latch is effective.
-Make sure that products such as nipple shields and pumps are not irritating the nipples.
-Try taking a warm shower and nurse baby immediately afterwards.
The warm water may open the Bleb and baby's sucking may draw out any blockage.
-Try applying a warm wet compress over the Bleb area, then immediately nurse baby.
7. Pregnancy - Are you pregnant?
If you are pregnant, congratulations!!!
Every baby is a precious gift from God! Please know that many women continue to breastfeed through pregnancy, resulting in healthy babies.
Child-led weaning means that the child gradually weans, according to their needs. They don't always wean when mom becomes pregnant, but many do.
Mothers who become pregnant while still nursing may experience nipple soreness. The soreness may last through the first trimester of pregnancy or longer.
A pregnant nursing mother's milk will eventually include colostrum, in preparation for the new baby that is coming, and the older baby may wean or start to nurse less, due to the different taste of the milk.
He may also wean because he is getting older and eating more solids, and he will naturally be less interested in nursing.
Understanding that nipple soreness in this case is due to hormonal changes, that her older nursing baby still needs to nurse, and understanding the benefits of child-led weaning, will often help moms to get through this phase.
For information on the benefits of Child-led weaning and
Tandem Nursing see Advantages of Breastfeeding.
For information on sore breast issues see Sore Breast Help.