NIPPLE PAIN

While nipple pain is common in the first 10 days of breastfeeding and during the infant’s teething process, sore nipples should not persist beyond this period and are often disregarded as “normal ” by many providers. Sore and painful nipples are NOT normal side effects of breastfeeding. Sore nipples may be due to abrasions that occur during feeding or from tight fitting clothing. These breaks in the skin pre-dispose the mother to infections of the nipple, as well as mastitis. Less common causes include psoriasis, eczema and contact dermatitis. Always bring mother in for a nipple and latch evaluation. Improper latch or flat/inverted nipples are common causes of nipple pain without infection. Consult with an IBCLC to evaluate latch depth and consider changing position during feeding or use of a nipple shield if indicated. If pumping, have mother bring in her pump and flanges to ensure a proper fit. Remember to evaluate the infant for ankyloglossia as a potential cause of nipple pain. For non-infected cracked nipples, breast milk combined with nipple cream, such as lanolin may promote healing thus we often encourage patients to express and apply breast milk to the healing nipple after and in-between feeds. Early intervention of skin breaks in the nipple is recommended to prevent secondary impetigo or candidiasis