Treating Nipple Cracks & Fissures

How do I care for my nipples when breastfeeding?

Nursing a baby can introduce you to many new sensations, but nipple pain shouldn’t be one of them. If you experience any discomfort when you initially latch your baby on, tell your lactation consultant as soon as possible. The earlier you get medical attention, the better the chances of resolving the problem without any long-term issues, such as damage or trauma to the breast.

In some women, nipple pain is not caused by trauma, cracked or bleeding nipples, but rather by a fungal infection of the nipple and areola called thrush, or Candida albicans. Read more about thrush and how to treat it here.

Look at your nipples and breasts before and after nursing your baby. Your nipples should have a normal tone and color, and should maintain their shape, especially after a feeding. If you have experienced bleeding from your nipples or areola tissue, you will need to determine exactly where the bleeding is coming from. There may be a crack in the nipple area or a tear along the line where the nipple inserts into the areola known as a fissure. Sometimes the tip of the nipple is tender and reddened from your baby’s tongue rubbing against it. In either case, the treatment plans are the same.

Latch-on and positioning are the key to healing:

• Use correct latch-on and positioning. Use back and lap pillows to support the baby and support yourself.
• Watch for your baby’s mouth opening wide to make sure your baby is latching onto the breast deeply, well past the nipple tip.
• Relax upon initial latch-on, take a few deep breaths, relax your shoulders and back and let the baby relax too.
• You should be able to notice the pain lessening with each new latch-on attempt. The first minute or two can be painful for about 15 to 30 seconds and then pain should decrease.
• Use a natural nipple cream, coconut or extra virgin olive oil on the nipple area after each feeding or pumping session. You do not need to wipe this off before feeding.
• You might need to apply a small amount of antibiotic ointment to begin the healing process (bacitracin or polysporin). You will need to wipe these ointments off the nipple before the next feeding or pumping session.

Your lactation consultant might also recommend that you:

• Massage breast milk onto the top of your nipple.
• Use soothing gel pads between feedings.
• Use breast shells to allow air to circulate around the nipple and create healing.
• Use nipple shields while nursing.

You might also consider pumping instead of breastfeeding for a couple of days. If these treatments don’t help within two or three days, you should contact your physician. There are many forms of medicated creams and ointments that can be prescribed to help heal your nipples. Speak with your lactation consultant to get advice on which option best suits your needs. Nursing should not be a painful experience. Get help to treat the pain and to create a comfortable and enjoyable breastfeeding experience for you and your baby.

Has nipple pain become a regular part of your breastfeeding experience? Share your challenges with us and one of our lactation consultants can help find specific solutions just for you.