Breastfeeds should be comfortable for both mum and baby.
So let's talk about nipple pain and how to prevent it.
In the early weeks, many mums feel some nipple tenderness, discomfort or pain when their baby first attaches. This is often mild and improves as the feed goes on.
For most mums, sore nipples stop being a problem after a few days or weeks. Nipple pain that continues, or is very severe, shows that something isn't quite right. Breastfeeding should be comfortable for you too!
What causes sore nipples?
In the early days, most sore nipples are caused by incorrect attachment to the breast. The nipple is rubbed and squashed between your baby’s tongue and the roof of their mouth. Your baby may not be taking a large enough mouthful of breast and/or not drawing your nipple far enough back into their mouth.
When your baby comes off the breast, you may notice that your nipple is squashed or more flat. You may see a line of swelling and redness across the nipple, a white area or even a small stripe of blood under the skin.
All these signs show that your baby was not attached properly and your nipple was being damaged.
Occasionally there may be problems with your baby's mouth, such as tongue-tie, which prevent them from attaching correctly, causing nipple damage.
Preventing sore nipples
You can help prevent damage to your nipples from the start by being extra careful about positioning and attachment. Baby-led attachment is very useful for helping babies to attach by themselves, even after the early weeks.
If you do have a sore or cracked nipple, this is usually only a short-term problem. With the right help and support, most mums find they can go on to breastfeed comfortably.
Step 1: Check your baby’s attachment.
Step 2: Get help with healing your nipples.
Could something else be causing it?
If you are sure your baby’s attachment is good but your nipples are sore or damaged, then there may be another cause to investigate. Sore nipples can be caused by:
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A poorly-fitting flange or high suction on an electric breast pump
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Prolonged use of a silicone milk catcher.
You may find it useful to contact one of our trained breastfeeding counsellors to discuss your situation further. They can help you work out whether you need to see your doctor.
My baby is older. I thought I was past all this.
As babies get older, there are sometimes new challenges.
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Teething can cause some babies to have problems with attachment, leading to biting.
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Hormonal changes can sometimes make nipples extra sensitive.
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Infections (as above) or other medical problems such as dermatitis can occur and you may need to see your doctor.
View the video below from Global Health Media about nipple pain and ways to improve your baby's attachment.
© Australian Breastfeeding Association February 2023
Find out more about managing sore nipples
Online interactive session free for members
Newborn Virtual Village - Comfortable attachment & early days support
Evidence-led info and practical tips from our Breastfeeding Information Series