Sore nipple still isn’t healing but baby latches well? It might be an infection.
What is the difference between sore nipples and a nipple infection?
Sore nipples usually happen because of poor attachment. Once you find the cause and manage it, the soreness goes away. Occasionally nipple pain persists because the nipple is infected.
You may have a nipple infection if:
-
Your baby is attaching and feeding well but you are still experiencing nipple pain beyond the first week.
-
The nipple pain starts after you've been feeding comfortably for a while.
-
Other causes of nipple pain have been ruled out, for example tongue-tie.
About 10% of breastfeeding mothers experience nipple or breast pain that's not associated with localised breast inflammation or mastitis. They often described the pain as 'burning', ‘stabbing’, ‘knife-like’, ‘shooting’ or ’sharp’.
What causes nipple infections?
Nipples can sometimes become infected with germs, like any other part of the body. Many different germs (bacteria, viruses and fungi) are found on the skin of healthy people. They don't usually cause any problems. But sometimes they can cause an infection, especially if the nipple skin is damaged or broken. This will delay healing of the damage already there. In some cases, these infections may occur even when your nipples don’t look damaged.1
It can be difficult to find out what germ is causing a nipple infection as different germs can cause similar signs and symptoms. See your doctor for diagnosis and treatment if you think you may have an infection.
How do I tell if I have a nipple infection?
Signs of infection on the nipples may include:
-
cracks that don't heal
-
redness
-
shiny areas
-
flaky or white spots
-
pus-like fluid or clear fluid coming from the nipple.
Or there may be no outward signs but you may have
-
sore nipples that are extremely sensitive (especially to light touch)
-
an itchy breast or nipple
-
stabbing or burning pain
-
deep pain or throbbing inside the breast
-
pain which may extend to the arm or back
-
pain starting during a feed and staying for some time afterwards.
What to do about a nipple infection?
-
See your doctor for diagnosis and treatment. Treatment will depend on what is causing the infection. One common treatment is a combined antifungal/antibacterial cream. In severe cases, you may have to take tablets. Your doctor will also check for other conditions, such as dermatitis, which may have similar symptoms.
-
Keep breastfeeding or feeding expressed breastmilk to your baby. It is safe to feed while you have a nipple or breast infection.
-
You don’t need to throw out any stored expressed breastmilk if you have a breast or nipple infection.2
If you or your baby have thrush
Thrush spreads easily. If you are being treated for thrush, your baby’s mouth is usually treated at the same time even if they don't have any symptoms. This will stop you and your baby passing the infection back and forth between you through breastfeeding.3
If you also have vaginal thrush or your baby has nappy rash, these can be treated too.
Careful hygiene is important until the thrush is gone.
-
Wash hands well before and after feeds and nappy changes.
-
Wash towels, face washers, bras and cloth breast pads often in hot water and dry them in the sun. Choose a laundry product designed for sensitive skin and rinse well.
-
Boil dummies as well as any toy that goes into your baby’s mouth. Put away any item that cannot cope with this treatment.
Access the Royal Women's Hospital, Victoria fact sheet on Breast and nipple thrush
© Australian Breastfeeding Association February 2023
- Amir LH, Cullinane M, Garland SM, Tabrizi SN, Donat SM, Bennett CM et al, 2011, The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol, Biomedical Central Pregnancy and Childbirth, 11(54): 1–10.
- Academy of Breastfeeding Medicine 2017 Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants. Retrieved from https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/8-human-milk-st….
- Royal Women’s Hospital. (2020). Breast and nipple thrush clinical guideline. https://www.thewomens.org.au/health-professionals/clinical-resources/clinical-guidelines-gps/
