10 Things Your Midwife Wants You To Know About Breastfeeding Nipple Pain

All you need to know to understand causes, and possible solutions, of nipple pain

nipple pain while breastfeeding causes and solutions
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Breastfeeding is an exquisite time with your brand new bundle of joy. Sometimes the only exquisite feeling is the pain in your nipple.

It’s hard to enjoy bonding time when your toes are curling. Shocked by the sensation? You are not alone.

As a Certified Nurse-Midwife and mom of four children, I have breastfed for nearly six years and cared for lots of breastfeeding mamas. Significant nipple pain causes many moms to terminate the breastfeeding relationship too soon.

Learning how to prevent nipple pain will ensure that you and your baby have a long, happy breastfeeding relationship that ends on your terms.

In this article, I will explain to you all you need to know to understand causes, and possible solutions, of nipple pain.



poor latch during breastfeeding can lead to nipple pain bleeding or blisters
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Breastfeeding should not feel like you have a little vampire on your nipple. If you’re uncomfortable while you nurse, your baby may have a shallow or improper latch.

Signs of poor latch include nipples that are bleeding or have cracks or blisters.

Try another position to see if the latch improves. If you are using cradle position, it may be putting painful pressure on one area of your nipple.

Switch it up by nursing your baby while side-lying or rotating baby to football hold.

Make sure the baby has the entire nipple and part of the surrounding breast in her mouth. You can achieve this by latching your baby on with her head tilted back and her chin pressed into your breast.

Her nose should be pointing away from the breast. If you continue to experience pain, consult a lactation specialist.



nipples look puffy red scaly with white spots because of thrush
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Do feedings result in a burning feeling? Are you experiencing a sensation like shards of glass are slicing through your breasts?

Thrush is the overgrowth of yeast on your nipples and in your breasts. Your nipples may look puffy, red, scaly, or covered in white spots.

Yeast thrives in warm and moist areas like baby’s mouth or your nipples. The sugar in breast milk enables the yeast to grow even faster. Thrush is passed between babies and mothers.

This results in white patches or small blisters around the baby’s cheeks, gums, and tongue. It also can cause a red, scaly, or shiny diaper rash that does not improve with diaper cream. Thrush results in a fussy baby who appears to be uncomfortable while sucking.

If you’re concerned about nipple pain that is caused by thrush, speak to your healthcare provider. If left untreated, the infection will pass back and forth between you and your baby. Your nipples usually will not heal without application of a medication to both your nipples and baby’s mouth.


Clogged milk duct

nipple pain from clogged milk duct
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A plugged duct is an area of the breast where milk flow is blocked. The duct can be in the nipple or further back in the breast ducts.

The clog usually appears slowly and affects one breast. It will feel hard and may be painful prior to feeding. It will usually improve after the breastfeeding session is complete.

If you’re experiencing a clogged milk duct, there are some steps you can take it to stop it from worsening.

    • Wear loose-fitting clothes and go without a bra while home to improve milk flow.
    • Before nursing, warm compresses, hot showers, baths, or a bowl filled with warm water will help loosen the clogged duct.
    • Use breast massage before you start feeding
    • Breastfeed at least every 2 hours to remove the plug.
    • Breast compressions while nursing or pumping will encourage complete emptying of your breast
  • Relaxing in the most comfortable position or hold and ensure a proper latch.
  • Laid-back breastfeeding is when you lie back and relax! Chilling out and nursing your baby has numerous benefits to empty your breasts, minimize nipple pain, and promote a healthy breastfeeding relationship with your baby.
  • Try to empty the breast with every feed, but do not neglect the other breast.
  • Some mothers with difficult clogs benefit from a special position called “dangle feeding” where you get on hands and knees. Place your baby under the affected breast and dangle the breast into your baby’s mouth. This allows gravity and your baby to work together to remove the clog.
  • If unable to nurse, use a breast pump to empty the breast.
  • Rest well, drink plenty of fluids, and make sure you’re eating well.

If your breast becomes tender, hot, swollen, or red, it may progress to a painful condition featuring flu-like symptoms called mastitis. In many cases, mastitis requires treatment with antibiotics.


Tongue or lip tie

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A baby with a tongue-tie has a frenulum that is very tight. The baby is unable to move her tongue normally and so she will increase the suction while breastfeeding. This can cause you significant pain and nipple damage.

If your baby lifts her tongue to the roof of her mouth while crying or sticks her tongue out past her bottom lip, there is most likely no issues with a tie.

However, if your baby is unable to make these movements, consult with your baby’s pediatrician. If you’re unsure whether it is a tongue-tie, speak with a lactation consultant or your baby’s pediatrician.

The treatment is a simple clip to the thin membrane that is causing the issues. When the procedure is complete, the improvements to breastfeeding and your nipple pain are nearly instantaneous.


Nipple Bleb

cause of nipple pain during breastfeeding
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A nipple bleb is a milk blister on the tip of the nipple. It is a blocked nipple opening that prevents milk from completely leaving the breast. If it is not cured, it can cause plugged ducts.

There are a few things you can try at home with a milk blister.

Before breastfeeding, soak your nipple in salt water and then apply a warm compress directly to the nipple. Using a washcloth, gently remove the milk blister.

Breastfeed your baby every 2-3 hours to clear the duct. After breastfeeding, you can soak the nipple in a salt-water solution. Let your nipples air dry, so you are not removing the saline solution.

Repeat until healed.

If this is not effective, speak to your healthcare provider.


Continue breastfeeding

don't stop breastfeeding in spite of nipple pain
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If you are experiencing nipple pain, there are many naysayers that will suggest you stop breastfeeding. If you suddenly stop breastfeeding, it can cause breast infections and decrease your breast milk supply.

Start with nursing on the non-affected side while your baby is hungry. When your baby is less hungry, she will not apply as much suction to the painful nipple.

If you’re unable to put your baby on the breast because the pain is severe, use a breast pump or hand express to keep your milk supply active and to stave off infection.


Warm Moist Heat and Breastmilk

how to alleviate breastfeeding nipple pain
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Warm, moist heat is ideal for taking care of nipple pain. It is both healing and soothing for sore nipples. If you are at risk for clogged ducts or engorgement, it will help prevent either from occurring.

To create a warm compress, use a washcloth soaked in warm water and squeezed out. Another option is applying a diaper filled with hot water directly to your nipple so that it stays warm longer.

Always test the temperature of the compress to ensure it is not too hot. Once the compress cools to room temperature, repeat the process.

If your nipple has any cracks or openings, squeeze out a few drops of breast milk and rub it into the painful area.

Leave your nipples open to air after breastfeeding. If you immediately put your bra back on, it will interfere with the healing results.

When you shower, do not use soap on your breasts. Allow warm water to run over your breasts, but do not scrub them.

If you’re looking for a gentle option for breasts that have been put through the wringer, try letting them air dry.


Triple Nipple Cream or All-purpose Nipple Ointment (APNO)

cream treatment for nipple pain
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This is the mother of all nipple creams because it treats a number of causes of nipple pain. It must be ordered by a healthcare provider and is compounded by a pharmacy.

The nipple cream contains three ingredients. The first is mupirocin, an antibacterial that has been shown to decrease nipple pain.

The second is betamethasone, a steroid that fights inflammation that plagues many breastfeeding mothers.

The third is miconazole, an antifungal that will knock out the yeast that can cause irritation in nursing moms.

If this does not heal your pain, you may need oral antibiotics to treat an underlying infection.


Hydrogel Pads

hydrogel pads for soar nipple protection
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Hydrogel pads create a soothing barrier for sore nipples. They are soothing and minimize friction from nursing pads or bra cups rubbing against your sore nipple.



lanolin can decrease nipple trauma during breastfeeding
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Lanolin ointment should be used daily for at least a week. Evidence shows that it decreases nipple pain and trauma.

nipple pain while breastfeeding causes and solutions
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Written by Caitlin Goodwin

Caitlin Goodwin is a board certified nurse-midwife, runs the family travel and autism blog, Typically Twitterpated and is a mom to four children. In her spare time, she and her family follow a gluten-free diet and share a love of all things travel, especially Disney.