Content:

• Causes of cracked nipples
• Risk of cracked nipples
• How to feed a baby with cracked nipples
• Is it necessary to stop breastfeeding with fissures
• How to organize the process of breastfeeding with cracks
• How to treat cracked nipples
• Prevention of cracked nipples

Breastfeeding a baby is an exciting and joyful process, but, alas, it does not always go smoothly. Approximately 10-15% of nursing mothers experience the problem of cracked nipples. They can occur from the first days of feeding, cause pain, discomfort, interfere. This problem requires a timely solution: you should not feed through force, it is better to take care of treatment in a timely manner. Neglecting the problem can make it worse.

Causes of cracked nipples

Cracks are easy to identify: they look like small wounds, scratches or tears in the skin in the nipple area. Sometimes injuries to the skin of the breast occur for reasons unrelated to the behavior of the mother and baby, but breastfeeding errors are much more common. They are often allowed by primiparas, who do not have experience and sufficient baggage of information. Although WHO recommends that physicians provide adequate information to patients both before and immediately after delivery [1], mothers can still face challenges.

Incorrect nipple latch. Doctors say it's a common cause of damage. Until now, many people believe that the capture of the nipple by a child during feeding is simple, and are perplexed when faced with the need to learn. The fact is that it is difficult to properly capture the breast for a baby, although he has a sucking reflex almost immediately. If breastfeeding is incorrect, only the tip of the nipple will be in the mouth of the baby, which will roll freely in the mouth during feeding. In an attempt to fix the chest, the baby will try to grab it with his gums, inadvertently injuring. You can understand that this is a problem by several signs:

• the child causes pain to the mother while feeding;
• baby does not fully grasp the areola during suckling.

Incorrect grip leads to the fact that after 2-3 feedings, microtraumas will appear on the surface of the nipple, which can subsequently turn into deep cracks.

Incorrect pumping. This problem is usually encountered by mothers who pump irregularly, for example, only in situations when they need to go somewhere. They lack experience to form a habit. If pumping is done manually, you do not need to press on the entire nipple: this is a common mistake that leads to microtrauma and damage.

Interfering with feeding. It happens that the mother mistakenly believes that the child has already eaten, and tries to wean him from the breast. The baby continues to eat and reflexively begins to grab the nipple, which leads to his injuries. So that weaning does not cause discomfort to the mother and does not lead to the appearance of cracks, you need to do this only when the baby is sure to eat, fall asleep and release the breast on his own. If, for some reason, the mother urgently needs to stop feeding, you can gently insert a finger into the baby's mouth, and only then remove the breast. This will help avoid injury. Also, do not abuse pacifiers: a baby accustomed to them squeezes the chest more.

Improper care of the skin of the mammary glands. Neglect of hygiene or, conversely, an excess of drying care products can also cause cracks. Soap, cosmetics, which contain alcohol - all this dries the skin, and overdried skin is easier to injure. Some people think that it is necessary to wash the breast with soap before each feeding. This is not so: daily hygiene procedures are enough. Improper care may also include:

• wearing underwear that is too tight or hard in unsuitable fabrics, underwired bras;
• use of powders and other laundry detergents that may cause allergies.

Cracks can also occur due to leaking milk residues. They are recommended to be removed. If a baby develops thrush in his mouth, this can also harm the sensitive skin of the chest - you need to carefully monitor the condition of the baby.

Skin diseases. Cracked nipples are often associated with other diseases, both infectious and non-infectious. For example, allergies or thrush can increase the risk of injury. In addition, diseases can develop against the background of cracks: injured skin is more vulnerable to infections. If you find signs of any illness, contact your doctor immediately. The specialist will prescribe treatment and give advice on what to do with feeding further, depending on the situation.

Sensitive skin. There is a situation when the baby is properly applied to the breast, but the nipples still crack and hurt. This may be due to the individual characteristics of the skin. If the skin is thin and sensitive, the mother usually knows about this in advance, but for reliability, you can consult a doctor. In such situations, the cracks are usually small and quickly heal, and the sensitivity gradually decreases. The longer a woman breastfeeds, the less discomfort she causes, until eventually it disappears completely. However, if the pain does not go away, this is a reason to consult a specialist.

Vascular problems. After milk has been sucked out of the breast, a spasm may occur in it. Nipples at such moments become hard and tense, hurt and change color. It is important to remember that in the event of a spasm, the nipple becomes especially vulnerable, so the breast should be treated with care. Discomfort will soon pass: vasospasm does not last long. To alleviate the condition, you can put a damp, warm towel or heating pad on your chest.

Danger of cracked nipples

It may seem that microtrauma does not cause much harm to the mother, but this is not so. It is not worth neglecting them and feeding through force, ignoring pain. In fact, injured nipple skin is an open door for a variety of infections. If bacteria get into the crack, an inflammatory process may begin, which will subsequently pass to the entire mammary gland. Cracks can cause mastitis.

In addition, inflammation can lead to serious consequences: you will need to drink medicines and possibly stop breastfeeding. Therefore, if cracks appear on the nipples, you need to pay attention to this immediately, do not endure and do not think that pain is normal. Cracks are easier to manage when they are still shallow; the more severe the injury, the longer it will take to heal.

How to feed a baby with cracked nipples

By themselves, microtraumas are not a reason to stop breastfeeding, but sometimes the pain during feeding is so severe that the mother begins to think about it. In reality, this is not at all necessary: ​​there are ways to continue breastfeeding your baby, even if cracks appear on the nipples. Breastfeeding is beneficial for both mother and baby. The baby receives all the substances he needs, the mother, in turn, releases the hormone oxytocin [2], which, among other things, contributes to the return to normal after childbirth.

Is it necessary to stop breastfeeding with fissures

No, this is completely optional if the cracks are not caused by an infection or have not become infected after they appeared. Of course, if the damage is deep, blood or ichor oozes from the injured nipple, you should not give it to the child. It is better to wait for complete healing. The same goes for inflammation, conditions in which the milk is contaminated or the baby can become infected through contact with the nipple. In such cases, you need to consult a doctor, consult with him about taking medication and the possibility of continuing to feed. You should not neglect a visit to the doctor, each case is individual and needs to be considered separately. If there is no infection or extensive damage, then there is no ban on feeding even if there are cracks. But there are ways to reduce the pain and reduce the risk of further injury to the breast.

How to Organize Breastfeeding with Fissures

• Attach the baby correctly to the breast, correctly remove it from the baby's mouth after feeding and hold the baby during feeding. You can learn this with the help of informational materials or specialists: doctors or lactation consultants [3], who will teach you how to properly attach your baby to the breast. According to some reports, this can reduce the risk of cracks by 50%;
• If only one breast is damaged, it is recommended not to feed it until the cracks have healed, and to use the second for the healing period.
• Special nipple covers for nursing can be used. They prevent the baby from squeezing the nipple and damaging the skin of the breast. There are also sanitary pads that are worn between feedings. Under them, you can apply a healing ointment.
• Feed the baby more often than usual. The more hungry the baby, the more intensively he sucks.
• It is recommended to start with a less damaged nipple: at the beginning of feeding, the baby sucks more actively.
• If the injury is severe, breastfeeding can be interrupted by expressing, then giving the baby the expressed milk. After wound healing, HB can be resumed.

How to treat cracked nipples

If the nipples are injured, treatment should be comprehensive. These are healing ointments and preparations containing vitamins: they are needed to strengthen and protect the skin. Overdried with soap or alcohol-containing products, the skin will need to be moisturized. The scheme in each case is individual and depends on the condition of the breast. You can consult with your doctor to better understand how to treat cracks in a particular case. Remember that drugs must be approved for use while breastfeeding.

Basic preparations. There are several basic products that can help with cracks:

• ointments and creams based on dexpanthenol. This substance is used as a wound healing, at the same time it increases skin regeneration, moisturizes and strengthens. It is used for burns, wounds, ulcers. Well-known means - "Panthenol-D" or "Bepanten". Funds are sold in different forms;
• preparations containing zinc. Zinc has an anti-inflammatory and antibacterial effect, avoids the penetration of infection into wounds, but dries the skin;
• products with lanolin, which has a moisturizing effect. It is recommended to eliminate dry skin;




Folk remedies. If the cracks are still shallow, there is no inflammation or infection, you can use folk methods. They are also used for prevention. They should be used with caution: remember that some herbs may cause allergies or not be suitable in a particular case, and untested remedies can do harm. To avoid this risk, check in advance if the method is safe and use only those that will not cause harm. This is the milk itself, which, according to some reports, has a wound-healing effect. You can gently anoint the nipples with breast milk and be without underwear for a while.

Remember that this does not always work, and if the defeat is serious, this will not be enough. In the case of inflammation, extensive damage or infection, consult a doctor and use the drugs that he will prescribe.

Prevention of cracked nipples

It is much easier to prevent painful and interfering cracks than it is to treat them. To reduce the risk of them occurring, you can:

• consult a doctor or use the services of a lactation consultant [3], who will teach you how to properly latch on. According to some reports, this can reduce the risk of cracks by 50%;
• start breast care in advance. Do not overdry it with soap or care products, and moisturizers, do not wear tight traumatic underwear;
• use hygienic liners and change them when wet, so that an excessively humid environment does not cause cracks;
• do not neglect hygiene, but also do not wash your breasts too often. A daily shower will suffice.

World medical organizations, in particular the WHO, agree that breast milk is the best food for an infant [1]. Moreover, breastfeeding can also be beneficial for the mother [2]. Therefore, you should not turn off the process when cracks occur, unless there are serious reasons for this. You can get rid of pain and injuries, and then feeding will not cause discomfort to either the baby or his mother.

[1] WHO: Breastfeeding

[2] Carlos Gonzalez "The Gift of a Lifetime: A Guide to Breastfeeding"

[3] William and Martha Sears "Your Baby from Birth to 2 Years"

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Cracked nipples | Medela

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