Cracked Nipples During Breastfeeding: Causes & Treatment

Motherhood is hard! There are many factors to consider when embarking on this journey, and ironically, a lot of these factors you only get to learn about after you’ve already become a mother.

I can’t count the number of times I’ve thought to myself ‘Gosh! I wish I knew this earlier!’

Cracked nipples during breastfeeding can make or break a woman. It’s a painful and fickle experience which can result in utter resignation of the entire process.

Let’s take a look at the causes, treatment, and prevention of cracked nipples during breastfeeding.

What are the Causes of Cracked Nipples During Breastfeeding?

Recognizing the signs is the first step to correct diagnosis and proper treatment.

There are a number of possible causes of cracked nipples during breastfeeding.

Improper Latch

The most likely reason you’re suffering from cracked nipples is because of an improper latch. Having issues with your baby’s latch can result in serious nipple pain.

Adjusting the way you nurse your baby can make all the difference when it comes to cracked nipples. Often, it can be the smallest adjustment that makes the most significant improvement.

Be sure your baby is opening their mouth wide when latching, and getting lots of breast tissue in their mouth. You can achieve this by pointing your nipple at baby’s nose, then bring the baby to the breast fast as soon as they open wide enough.

Poor Positioning

If your baby has to turn his head to latch, chances are that while they’re nursing, they’ll try to get back to an aligned position – and pull your nipple along with them, which can cause a great deal of damage.

Be sure baby is turned completely toward mom when latching, with no space in between their bodies.

Misusing Breast Pumps

Another way to develop cracked nipples is by using a breast pump the wrong way.

All too often, women pump on the highest possible setting the machine offers, putting too much pressure on their nipples in the process.

Small Breast Pump Flanges

Breast pumps also come with a flange – that funnel-like part that covers the breast.

If this part is too small, you could be doing more harm than good when your nipple rubs against the inside of the tunnel.

Thrush

Your baby could also develop thrush.

Because this is a fungal infection, it can be passed onto you when your baby is breastfeeding. Or, you may develop thrush and pass it on to baby.

Look out for signs of thrush including inflammation and itchiness.

Eczema

If you already suffer from eczema, this could be another cause of cracked nipples. Your nipples will be scaly with red patches of skin.

How Can I Tell Between Normal and Abnormal Nipple Pain While Breastfeeding?

In most circumstances, most women will experience some sort of pain during breastfeeding. However, there’s a marked difference between normal and abnormal nipple pain while breastfeeding.

Let’s discuss the variations you can look out for.

It’s normal for you to experience nipple pain during the first ten days of breastfeeding. This is due to both you and the baby getting used to the feeding process.

You can also experience pain during breastfeeding if your baby’s teeth are coming through. There will be a transition period where they adjust their latch, so both you and baby are more comfortable.

When is pain abnormal, then? The blanket rule is any other time during the breastfeeding process. If you’re experiencing pain beyond the 10-day mark, or your baby isn’t teething, you may want to seek medical advice.

Why Is It Important For Me To Treat My Cracked Nipples?

We’ve covered the causes of cracked nipples and how to tell if the pain you’re experiencing is abnormal or not.

However, just how important is getting your cracked nipples treated properly? Will the problem and pain just go away with time or should you actively be doing something about it?

It’s essential you take cracked nipples seriously and get the appropriate treatment you need.

Cracked nipples are open sores on the surface of your nipples. This means there is the potential for the outside environment to come into contact with the exposed tissue underneath. If bacteria get into your breast because you have cracked nipples, you risk mastitis.

Mastitis is a serious condition that can result in a fever and infection, and is usually treated with antibiotics. Some cases are more severe than others.

How Can I Breastfeed With Cracked Nipples?

If you haven’t got any blood-borne diseases and don’t have the tail-end of an infection, it is okay for your baby to swallow a little bit of blood when feeding on cracked nipples.

In fact, experts recommend that you continue breastfeeding and don’t stop just because of this.

Having cracked nipples does not necessarily mean you have to stop breastfeeding straight away. While you may find a bit of blood in your baby’s stool, do not be alarmed.

There are ways to successfully manage the pain and bleeding of cracked nipples while you’re still breastfeeding.

Make sure that your baby is feeding in the correct position. Your baby should be latched on to the nipple and areola – this is the dark area around the nipple.

Reducing the engorgement of your breasts by expressing before feeds can bring relief. You can do so either by hand expressing or with a breast pump.

To soften the breasts before feeds, try a hot compress or having a hot shower. Applying heat to your breasts can relax the muscles and encourage an easy let down when it comes time to feed.

If you are experiencing more pain in one breast than the other, we recommend alternating your feeds. Try to limit the feeding time on the more painful breast – this can give it time to heal.

While the last thing you feel like at this point is breastfeeding, it’s vital that you continue to do so frequently. If you are avoiding feeding because of sore nipples, you may endanger your milk supply.

If it hurts too much to feed, let baby nurse on the less sore breast, and pump the more sore side. Doing this for 24 hours should let healing begin since you’re giving the more sore side a rest while preserving your milk supply in the process.

When Should I Throw In The Towel?

At some point, you’re going to feel like giving up. However, with the right education and support, you can successfully continue to breastfeed.

While most experts would strongly encourage you to push through and continue to breastfeed during this phase, it’s also normal that in some situations it’s just not realistic to carry on.

If the pain and discomfort are unbearable, rest one or both of your breasts for a period of 24 to 48 hours. During this time, use a pump or hand express your milk so that your baby can continue to feed.

This will also benefit you – continuing to express will reduce the risk of mastitis.

If possible, use a hospital grade pump to drain the milk. You can use a spoon, dropper, or syringe to feed your baby the expressed milk. If your baby is younger than four weeks, using a bottle is not recommended as this could result in nipple confusion.

Using a bottle could further complicate the situation if your baby is already struggling to maintain a good latch.

How Can I Minimize the Pain and Discomfort?

Let’s take a look at some great ways to successfully manage the pain and discomfort of cracked nipples while you’re breastfeeding:

Self-Latch

You may have already tried to get a good latch for your baby.

However, your little one has natural instincts. Their innate breastfeeding abilities will allow them to find the nipple and develop a good, strong latch that suits their feeding needs.

Hunger Cues

If you wait for as long as possible to feed your baby again, we understand. However, this could result in more pain.

Try looking for early hunger cues. These will include your baby turning its head to the side, making sucking noises, and even pushing their tongue in and out.

If you catch early cues, their sucking may be less intense, saving your some pain.

Nipple Shields

While experts don’t typically recommend nipple shields to protect your cracked nipples when your baby is feeding, they’re a good tool if the pain is so intense to the extent that you’re considering weaning.

Nipple shields are made out of silicone and sit over the nipple. The baby will latch onto your breast through the shield, without contacting your breast at all.

Airing Out

Your nipples need time to heal without being touched. When you’re breastfeeding, this is easier said than done.

Try using a breast shell to prevent your bra from rubbing against your nipples when you’re not feeding. Giving your nipples time to be exposed to air can keep them dry and accelerate the healing process.

Are There Any Remedies for Cracked Nipples?

Let’s discuss some practical remedies that you can try out:

Breast Milk

Breast milk isn’t just liquid gold for your baby. Breast milk has antibacterial and healing properties that can help heal your cracked nipples.

Apply a few drops on your nipple before and after breastfeeding using a clean finger, and allow the milk to dry.

Coconut or Olive Oil

Dab this on with a clean cotton ball after each feeding. These oils can provide a soothing moisture barrier, allowing the nipple to begin healing.

Peppermint Gel

Peppermint gel is not only soothing, but can help with healing. Be sure to buy a product made specifically for breastfeeding.

Lanolin-Based Nipple Cream

This purified lanolin product creates a moist wound barried that speeds healing.

These creams are typically easy to find locally, and are an inexpensive option.

Medical Grade Honey

This isn’t the honey found in the food aisles, but instead one purified for medicinal purposes.

It has antibacterial properties and many moms find it soothing.

Hydrogel Pads

These are like a bandage for your nipple. They allow air in while protecting the skin and letting it heal.

When Should I See A Doctor Or Take Medicine for My Cracked Nipples?

As important as it is to know how to prevent your cracked nipples from worsening, it’s also important to understand why you’re experiencing all of this in the first place.

We’ve covered most possible causes of cracked nipples. However, there are some other reasons. With these, we recommend involving your doctor.

One potential cause is a tongue-tie in your baby. This is when your baby’s tongue is tied to the floor of their mouth by a piece of skin. This can cause your baby to pinch when breastfeeding, resulting in cracked nipples.

If your doctor diagnoses a tongue tie in your infant, they can successfully treat this by cutting the piece of skin.

To manage your cracked nipples until your baby can develop a good latch, your doctor may recommend medical-grade lanolin.

This ointment is designed to promote moist healing in cracked nipples, while you’re breastfeeding. The best part? You don’t even need to worry about having to wipe it away in between one feed and another.

Getting Advice from a Lactation Consultant

Can a lactation consultant help with your cracked nipples? If so, when should you call?

We point to a review regarding the effectiveness of lactation consultants in relation to new mothers who are learning to breastfeed.

It concluded that mothers who were provided with a lactation consultant were provided the correct education and support they needed. This helped their breastfeeding and nipple issues go away.

If you’re suffering from cracked nipples and feel overwhelmed as you get used to breastfeeding, we recommend calling a lactation consultant. A lactation consultant can help with your cracked nipples problems because they can observe first-hand the problems you’re facing with breastfeeding in general.

From practical latch tips to correct positioning of your baby and moral support, a lactation consultant is a new mothers’ best friend. They can also provide you with feeding strategies tailor-made for your unique experience.

Because most causes of cracked nipples have to do with feeds, a lactation consultant will be able to show you how to manage, treat and prevent adequately.

Cracked nipples can result in emotional frustration as well. Sometimes just having the reassurance of a medical professional can boost your confidence and encourage you to soldier on.

Coping with Cracked Nipples During Breastfeeding

There’s nothing worse than experiencing pain with breastfeeding.

You’re already tired from parenting a newborn, your body is still healing from the birth, and you haven’t even been able to process the fact that you’re now a mother. That’s not an easy responsibility to “swallow” just like that!

Cracked nipples can take a huge toll when experiencing motherhood for the first time, and they are one common reason women stop breastfeeding (source).

The more you know about what’s causing your problems, the better equipped you will be to treat them correctly, ensuring you can continue your breastfeeding relationship comfortably.

Depending on how severe your case is, you may be able to make these troubles go away entirely, or you may only be able to prevent them from getting worse.

With our in-depth guide to cracked nipples during breastfeeding, you can feel confident enough to tackle them head-on!

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Medically Reviewed By: Michelle Roth, BA, LCCE, IBCLC

Medically Reviewed By: Michelle Roth, BA, LCCE, IBCLC

Michelle Roth, BA, LCCE, IBCLC is a board-certified lactation consultant for two busy pediatric practices. She is a former La Leche League Leader, Lamaze Certified Childbirth Educator, and Certified Infant Massage Instructor. She has taught classes ranging from healthy pregnancy, to childbirth preparation, to parenting, and more.

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