As you get the hang of breastfeeding your newborn, it’s not uncommon to experience sore, tender, cracked, blistered, and even bleeding nipples. Luckily, there are steps you can take to help prevent such discomfort, as well as things you can do to care for your breasts when soreness and cracking occurs. Eventually your nipples will heal and toughen up, but first let’s look at the possible underlying causes of cracked and sore nipples:

What causes sore and cracked nipples?

Uncomfortable breastfeeding positions causing poor attachment

Some positions can cause your baby to squash the nipple as they feed, which can make it painful, or may damage the nipple or restrict milk flow. You could try letting your baby lead the way. Breastfeeding is instinctive for babies, so allow your baby to position their chin, head, and neck in a way that feels comfortable to them. To attach deeply, your baby needs to be able to open their mouth wide and swallow easily.

Pumping equipment is ill-fitting or too rigorous

If you’re expressing, the pump flange could be too big or too small, possibly leading to nipple pain or blisters. You may need to try a different pump that is adjustable to fit your breasts better. Also, lowering the speed setting could help to minimise chafing and pulling at your nipples.

An ill-fitting nursing bra could be putting excess pressure on the nipples

Get professionally fitted for a nursing bra if possible, or take your own measurements to get the right size. Chances are your breasts are bigger than when you were pregnant and bought your bras.

A clogged milk duct, yeast infection, or mastitis

A clogged milk duct can cause blisters, while a yeast infection can cause sharp, burning pain during breastfeeding. Mastitis is a potentially serious breast infection that can result in severe breast and nipple soreness, redness and heat in the infected area, and even a fever.

Caring for sore and cracked nipples while breastfeeding

Breastfeeding is a learned skill, and like any new skill, it requires practice, patience, and gradual progress to understand what works and what doesn’t. Between what feels like endless feeds in the beginning, this is what you can do to keep your nipples healthy and as pain-free as possible:

To prevent sore and cracked nipples

1. Use only water to wash your breasts, and leave out any soaps or cleansers.
2. Expose your nipples to the air after each feeding to ensure they’re dry before you cover them back up again. If you live in a humid climate, you might like to use a cool fan or hairdryer set to low heat to assist the drying process.
3. Change your nursing pads often, as it’s important to keep your nipples dry to prevent bacteria growth.
4. Use a soothing cool compress or nipple balmMustela Nursing Comfort Balm Review, which will help to form a protective barrier.
5. To further care for your breasts and prevent stretch marks appearing, you might like to use a stretch marks cream that’s compatible with breastfeeding. It will help to soothe the feeling of tightness and leave your skin soft.

To care for sore and cracked nipples

1. Hand-express some milk to soften the areola and lubricate the nipples before and after feeds.
2.  Offer the less sore nipple first when your baby is showing early hunger signs.
3. Try different feeding positions if it’s painful.
4. You may feel more comfortable gently or manually expressing, and then feeding your baby pumped milk until your nipples have healed.
5. Wash breasts daily in the shower with warm water to avoid infection. Pat dry using a soft towel.
6. Use a compress to cool and soothe between feeds.
7. For blisters, you might find relief from a warm compress prior to feeding your baby.
8. Consult a lactation consultant. She will check your positioning, your baby’s latch, and look for any medical causes such as dermatitis or infection, or anatomical causes such as tongue-tie.

See your doctor if you require pain relief or suspect a medical cause. Contact an Australian Breastfeeding Association counsellor or your maternal and child health nurse.