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Your ultimate guide to nipple care during breastfeeding

medico-author

Written byMedico Digital

Peaceful loving young African mother sitting on bed and leaning on headboard while feeding baby with breast
Wondering what’s causing nipple pain while breastfeeding? We look at the top reasons behind nipple discomfort, ways to prevent it and tips to relieve pain so you can focus on bonding with your baby

Summary

1Is it normal to have nipple pain breastfeeding?

Nipple pain is very common, especially in the first week after your baby is born, and it’s one of the most common reasons for introducing formula…

2How to relieve sore and painful nipples

If the pain isn’t down to your baby’s latch, these tips may help: only wash your breasts with water (soap can dry them out), massage breast milk on...

3Nipple care routine for breastfeeding mums

Consistent nipple care routine can make you more comfortable when breastfeeding. Try to wear cotton, non-underwired bras to allow air to circulate...

Explore related topics

Breastfeeding can be a beautiful bonding experience and a way to give your baby the best start in life. But for some new parents, nipple pain and discomfort can turn breastfeeding into an uncomfortable (and even overwhelming) task. 

Sound familiar? Over 70% of mums experience nipple pain or discomfort in the first week after their baby is born.1

It’s completely normal to feel frustrated or even tempted to give up breastfeeding, but with the right care and support, you can overcome these challenges and keep going.

Let’s talk about what causes nipple pain and discomfort, explore tips for breastfeeding nipple care and find out when it's time to ask for professional support.

Common nipple problems during breastfeeding

Many breastfeeding parents encounter nipple issues along the way, and it's important to remember that you're not alone in facing these hurdles. Here are some common challenges and nipple problems breastfeeding mums may encounter along the way.

Irritated and sore nipples

When your baby starts breastfeeding, it’s a big adjustment for your nipples. They’re suddenly experiencing friction, pressure and suction multiple times a day while you and your baby learn how to feed together. 

This causes the skin of the nipple and areola area to stretch and change, and puts it under a lot of stress, sometimes leading to damage.2 It’s no wonder that these changes can cause irritation and pain! 

If you experience nipple pain when breastfeeding, it could be a sign that something isn’t quite right. Depending on the symptoms you’re having, issues with positioning, your baby’s feeding technique, infections and problems with the breast itself can all be responsible.2
 

Nipple pain while breastfeeding

Nipple pain is very common, especially in the first week after your baby is born, and it’s one of the most common reasons for introducing formula or stopping breastfeeding.2

Generally speaking, the usual culprits for nipple pain while breastfeeding are the positioning of your baby and a poor latch (when your baby hasn’t got a hold of enough breast tissue in their mouth and is only sucking the nipple).1,3 

But whatever the cause, it’s important to correct a poor latch quickly to make sure your baby is getting the nutrients they need and to improve your pain. Don’t hesitate to reach out to your healthcare professional or breastfeeding specialist such as an IBCLC lactation consultant for guidance if you’re worried about your baby’s latch. 

Other causes of nipple pain when breastfeeding include:2 
  • nipple vasospasm – this occurs when the blood vessels in the breast tighten, causing pain 
  • dry skin – this can happen due to a skin condition (like eczema) or frequent breastfeeding 
  • bacterial infection – often occurs after a break in the skin 
  • tongue tie – restricted tongue function can affect how well a baby is able to latch and maintain feeding
If any of these sound familiar, don't be afraid to seek experienced, specialist support quickly to address the issue.
 

Breastfeeding nipple cracks and blisters

Usually, cracked, sore, blistered or bleeding nipples are a sign of poor positioning and friction during feeds.

To avoid this, make sure your nipple is positioned far back into your baby’s soft palate. If it’s not far back enough, your nipple may be squeezed against the baby’s hard palate, leading to pain and damage.3

Some breastfeeding positions, like laid-back breastfeeding, have been shown to improve a baby's latch and reduce nipple pain and trauma.4 Experimenting with different positions may help reduce pain and prevent damage to your nipples.4 

If your skin is damaged, there's an increased risk of developing a bacterial infection. Get help early to prevent the situation from worsening. Rubbing expressed breast milk onto your cracked nipples after feeding can also help soothe pain and reduce the risk of infection.5
 

Itching and discomfort

Common causes of itchy nipples when breastfeeding include:2
There’s some evidence that regularly moisturising the nipple with nipple balm, cream or ointment may be helpful for skin dryness and conditions such as eczema.6

If the itching or discomfort persists, or if you notice signs of infection such as redness and swelling, it’s important to discuss your symptoms with a breastfeeding specialist to help rule out positioning or other issues or visit your GP for advice and treatment.
 

How to relieve sore and painful nipples when breastfeeding

If your nipple pain is caused by a poor latch, it’s crucial to seek advice from a breastfeeding specialist to improve your technique. 

Your midwife can refer you to your local Infant Feeding Team or breastfeeding support group. A one-to-one appointment with a breastfeeding specialist can provide time to fully review what’s happening and work on improvements together. 

Optimising a baby's latch is the most common solution for painful nipples. Trying a different position (such as laid-back breastfeeding)4 can make a significant difference to your comfort.

Where the pain isn’t down to your baby’s latch, the following tips may help: 
  • only wash your breasts with water (soap can dry them out)7
  • change your breastfeeding pads (if you use them) after every feed7
  • avoid the temptation to feed less often – your baby needs to feed, and cutting back on feeds may affect your milk supply8
  • massage breast milk onto your nipples after feeding5
  • seek specialist breastfeeding help early for cracked nipples or blisters to prevent ongoing pain and the risk of infection 
Although there’s only limited evidence to their benefits, some women turn to nipple balms and ointments to help soothe their sore nipples.5

Nipple balm for sore nipples

If you’re looking for something to protect your nipples when breastfeeding, expressed breast milk is one of the most evidence-backed remedies.2,5 However, there are also a variety of nipple creams available on the market. 

According to one study, using nipple balms that contain lanolin may help women with nipple pain continue to breastfeed for 25% longer than mums using other remedies.9

Other studies have found no benefit to using lanolin over other creams, or even using nothing, in terms of nipple pain.5,10 Despite this, many mums choose lanolin-containing nipple balms because lanolin is tasteless and doesn’t need to be removed before breastfeeding.10

Nipple care routine for breastfeeding mums

A consistent nipple care routine can make you more comfortable when breastfeeding. Try to wear cotton, non-underwired bras to allow air to circulate, and remember, don’t use soap on your breasts.3 Before feeding, there’s no need to clean your breasts, but you can wash your hands.7 
mother using breast pump machine to pumping milk while father feeding milk bottle to infant baby on a sofa in the living room at night
When feeding, make sure your baby has a good latch. Allow them to nurse for as long as they need to – don’t try to stop them early.3 If you’re pumping, use a low-pressure setting, as higher-pressure settings are linked to nipple pain.1

After feeding, allow your nipples to air dry before redressing and changing any wet breast pads. The NHS doesn’t routinely recommend using nipple shields or breast shells.3

The final say

It’s normal for nipples to be a little sore in the first days and weeks of breastfeeding, but good nipple care alongside optimal positioning may help with this.1 

However, severe nipple or breast pain isn’t a normal part of breastfeeding and may be a sign of a poor latch, an infection such as mastitis or another issue.3 Seek advice from a health professional or breastfeeding specialist early on to prevent things from getting worse. You can also call the National Breastfeeding Helpline on 0300 100 0212.

Want to know more about how to take care of yourself when breastfeeding? Check out our articles on breastfeeding supplements and breastfeeding-safe skincare.

Disclaimer

While we strive for accuracy and balance, please be aware that this article may discuss products available for purchase through Holland & Barrett. Consult a healthcare professional before making any health-related decisions.
 

Sources

1. Amir LH, et al. Identifying the cause of breast and nipple pain during lactation. BMJ. 2021;374:n1628. https://doi.org/10.1136/bmj.n1628 
2‌. Douglas P. Re-thinking lactation-related nipple pain and damage. Women’s Health (Londo). 2022;18:17455057221087865. https://doi.org/10.1177/17455057221087865 
3. NHS. Sore or cracked nipples when breastfeeding [Internet]. [Accessed 2024 Nov 4]. Available from: https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/sore-nipples/ 
4. Wang Z, et al. The effectiveness of the laid-back position on lactation-related nipple problems and comfort: A meta-analysis. BMC Pregnancy Childbirth. 2021;21(1):248. https://doi.org/10.1186/s12884-021-03714-8 
5. Dennis CL, et al. Interventions for treating painful nipples among breastfeeding women. Cochrane Database Syst Rev. 2014;2014(12):CD007366. https://doi.org/10.1002/14651858.CD007366.pub2 
6. Reynaert V, et al. Nipple eczema: A systematic review and practical recommendations. J Eur Acad Dermatol Venereol. 2023;37(6):1149–59. https://doi.org/10.1111/jdv.18920 
7. NHS. Sore nipples - Breastfeeding challenges - Start for Life [Internet]. nhs.uk. 2023. Available from: https://www.nhs.uk/start-for-life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/sore-nipples/
8. ‌Kent JC, et al. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs. 2012 Jan;41(1):114–21. https://doi.org/10.1111/j.1552-6909.2011.01313.x 
9. Bourdillon K, et al. Latch-related nipple pain in breastfeeding women: the impact on breastfeeding outcomes. British Journal of Midwifery. 2020;28(7):406–14. https://doi.org/10.12968/bjom.2020.28.7.406 
1‌0. LactMed. Lanolin [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501842/
 

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