Nipple soreness that’s due only to the baby’s suck should improve after the initial latch-on and should greatly improve, even diminish, after the first week postpartum, or two weeks at most. If your pain persists throughout the feeding, even after the milk is flowing, or if it is not improving after the first week postpartum then you may need to make some adjustments. Don’t be alarmed but do take your body’s pain signals seriously. Respect what your body is trying to communicate with you. More often than not it’s something simple such as improper latching, but to ensure successful long-term nursing you will want to address the source of the pain right away.
I will start by sharing an anecdotal story about what I experienced with my first daughter. The first few days postpartum the midwives showed me how to ensure a good latch-on and my daughter and I were doing great. However, after a few days, as I was getting less sleep and nursing her in new positions I forgot the importance of having my baby’s belly against my belly. I allowed her body to turn away from my body while she nursed. I didn’t realize that she was pulling my nipple with her and slowly causing a tear on the underside of the nipple. I didn’t see the tear for a few days and I figured it was regular nipple soreness. I covered my nipples with lanolin-cream and remained topless or with loose cotton shirts as much as possible. But the pain was increasing and becoming unbearable. I was waking my husband up at night to support me through my pain and tears while I nursed.
I suspected thrush and almost went ahead with treatment before finally realizing that I wasn’t just experiencing regular nipple soreness and cracking, but a poor latch. Even after noticing the tear I wasn’t about to stop nursing my precious newborn to allow my skin to heal and to ease my pain. I answered to her hungry cries and I was in agony throughout each nursing. But within a day after realizing my mistake and now ensuring that her body was in the correct position each time she nursed, my nipples started healing and the pain did begin to lessen dramatically.
The point of this story is that you may have had a good latch-on initially. But still watch out for proper positioning and be very precise until your nipples toughen up by about six weeks postpartum. If you do experience cracking from improper latching, remember not to give up. The pain can be unbearable, but if you address its source it will improve very quickly. For tips about getting your baby to latch on, please review my article “Getting Baby to Latch On”. Here are a few guidelines to keep in mind:
· A horizontal red stripe across the tip of your nipples is a sign of improper latching. It indicates that your baby is sucking on the nipple instead of the areola.
· Make sure that both of your baby’s lips are turned out.
· Your baby’s tongue should be over her bottom gum and between her lower lip and your breast.
· Press the front of your baby’s body against your body.
· Don’t be afraid to take your baby off your breast several times to ensure a proper latch.
· Start nursing on the less sore nipple. You can switch your baby to the more sore side after the milk ejection reflex has occurred. Or you can empty the less sore one first. The pain is sometimes reduced once the milk is flowing.
· If your baby needs comfort sucking use your finger or have your partner help with his pinky. While comfort sucking on the breast may be too painful for you to endure at this time, you also do not want to introduce a pacifier at this sensitive stage. To ensure proper latching hold off with a pacifier at least until breastfeeding is established and stable.
· You can numb your nipples with ice before nursing if the pain is unbearable.
· Make sure to empty your breasts and avoid engorgement, which is a whole other reason for sore nipples.
Caring for sore nipples
There are two methods of healing sore and cracked skin. Moist wound healing and dry healing. You can try both and see what feels good to you. In the moist healing option soothe your nipples after each nursing session with lanolin ointment. Be sure to use one that has been cleaned and approved for nursing babies, such as Lansinoh. The ointment encourages the skin to retain its natural moisture and heal.
With the dry method you will want to allow your nipples to dry after each nursing session. It is best to be topless, especially at night. Don’t use soap on your breasts as this removes the natural oils of the nipples. The little bumps around your nipples are glands that secrete a natural cleansing and lubricating oil. Be sure that your braw or shirt is not too tight or rough and doesn’t irritate your skin.
What about breast shells and nipple shields?
If you have addressed the cause of your sore nipples, but they are still too tender to even touch soft fabric, then you can have a temporary relief while your skin heals. Breast shells can sometimes be obtained from lactation consultants. They cover the breast and provide protection for the nipple. Remember that they will only be helpful if you are addressing the cause of the problem.
In contrast to the breast shield, a nipple shield is a soft silicone cover for the nipple and areola only. The baby can nurse with this cover on. However, there are some risks with the nipple shield. The baby gets as little as 20-50% less milk through the shield. Be sure that the baby’s lips are positioned high on the areola. Additionally, the baby can have a hard time latching onto the nipple alone after getting used to a nipple shield. So be sure the shield is used only temporarily while you get help from the nursing consultant. You may be able to use the shield for the initial nursing and then slip it out once the letdown reflex has occurred and re-latch the baby onto your nipple.
Still sore nipples
If you have tried everything and you are still in pain I highly recommend that you see a lactation consultant. There is only so much advice I can give through an article or a website. Each woman, baby and nursing situation is unique. Sometimes we simply need help from another human being by our side and we cannot do everything on our own. Sometimes nipple pain can be a medical problem such as vascular irregularities or infection, which require a lactation consultant or medical attention.
The problems and solutions for successful breastfeeding are numerous. I am doing everything I can to write as many helpful and informative articles as I can about the various stumbling blocks of nursing. As I’ve stated in previous articles, I believe and know to be true that some women and babies have unique situations in which nursing is not optimal and sometimes not possible. However, I believe that God created 99% of women and babies to be able to successfully nurse. Everyone knows that breast-milk is the optimal nourishment for newborn babies. I thank God for formula and other leading edge technological and scientific advancements that save the life of women and babies every day all over the world. I hope to do my part to help women and babies have positive and thriving nursing experiences.