How to clean nipples

How to Protect Your Nipples When Breastfeeding

Written by WebMD Editorial Contributors

Reviewed by Dan Brennan, MD on March 08, 2021

In this Article

• How to Care for Your Nipples While Breastfeeding
• When to Consider Seeking Help

Breastfeeding is a natural process that should be a good experience for both you and your baby. It helps mom and baby bond together, and breastmilk has all the nutrients that a growing baby needs. However, it takes a little practice and patience to get it just right.

Many new moms may experience nipple soreness or discomfort when first starting out. This can be caused by the baby’s position, latch, or sucking. Luckily, there are several ways that you can correct this and care for your nipples to make sure breastfeeding is a special experience for both you and your baby.

How to Care for Your Nipples While Breastfeeding

While you’re breastfeeding, you should make of habit of checking your breasts and nipples on a regular basis. By doing this, you might be able to identify any possible problems before they get worse down the road.

Regular Breast and Nipple Care

While breastfeeding, follow these steps:

1. Wash your hands with soap and water before each feeding. You should only touch your breasts and nipples with clean hands.
2. Wear a clean bra with proper support each day. Nursing bras are typically the easiest to use while breastfeeding. Cotton bras also breathe better and allow air to circulate.
3. Avoid using soap or shampoo on your nipples. Wash your nipples with just water, as soaps can remove your natural lubrication. This lubrication prevents your nipples from drying out and cracking while nursing.
4. After each feeding, put a few drops of breastmilk on your nipples. This helps to moisturize your nipple and fight off possible infections.

Sore Nipples Caused by Latching

Breastfeeding shouldn’t hurt, so if you find that one or both of your nipples is sore after a feeding, that’s a sign that your baby might not be latching correctly. This is the most common cause of nipple soreness while nursing. You might have to try a few different positions while holding your baby to find the correct one.

If your baby is latching correctly, your nipple should rest against their soft palate and shouldn’t cause any pain or discomfort. Correcting this positioning should make it much easier for your sore nipples to heal.

Another sign that your baby isn’t latching correctly is if you notice your nipples becoming flat, wedge-shaped, or white in color. To help your baby get a good latch, lightly tickle them so that they open their mouth up wide. Point your nipple up towards your baby’s nose and upper lip so that they can get more of your areola in their mouth and not just the nipple.

Caring for Sore Nipples

If you’re performing regular breast and nipple care and are still experiencing soreness, there are a few at-home treatments that you can try.

1. Change your nursing pads when they become wet. Try to avoid using nursing pads that are lined with plastic.
2. Don’t wipe off your nipples after nursing. After each feeding, allow your nipples to air dry naturally for 10 to 15 minutes.
3. Try taking over-the-counter medication to help with the pain, like acetaminophen or ibuprofen.
4. Avoid using nipple shields. They don’t improve your baby’s latch and could further irritate your nipples.
5. Pumping your breastmilk using a low-pressure setting can help your nipples heal.
6. You can apply 100% pure lanolin to your nipples with a cotton swab after feeding to help with soreness.
7. Let the baby nurse for as long as they need to. A common misconception is that short feedings can prevent sore nipples, but this is not true.

When to Consider Seeking Help

If you’re still having pain or soreness, you may want to reach out to a midwife or lactation consultant. They can help you determine whether your soreness is caused by improper latching or something else. If the cause is an improper latch, they can show you different positions or techniques to get it right.

Apart from poor positioning while feeding, soreness can also be caused by a number of different factors.

• Your baby may have tongue-tie. This occurs when the frenulum, or the string of tissue under the tongue, is short and restricts the movement of the tongue. This can prevent your baby from getting a good latch.
• An infection of the nipple.
• Certain skin conditions, like eczema, dermatitis, or psoriasis can cause nipple pain while nursing.
• Vasospasm, which is the tightening of the blood vessels that surround the nipple.
• A plugged milk duct or mastitis, which causes a hard knot to form in the breast.

Seeking out care can help you find the cause of your pain so you can correct it and get back to healthy, painless breastfeeding.

Nipple care for breastfeeding mums | Breast care

Although breastfeeding is good for you and your baby, it can be hard on your nipples! Read our advice and tips on nipple care to help keep soreness at bay

Share this content

Sioned Hilton, health visitor, neonatal nurse and lactation consultant:
Mum-of-three Sioned has been supporting families with babies and young children for more than 30 years. As well working with breastfeeding and expressing mothers, both in hospitals and the community, she contributes to parenting magazines and conferences, and delivers workshops for healthcare professionals.

“Breastfeeding shouldn’t hurt” is a mantra new mums often hear. But many find the reality is rather different in the early days.

For starters, during pregnancy most women’s nipples become larger and more sensitive. And when your newborn starts feeding from them he creates pressure and suction unlike anything they’ve ever experienced before (well, if you’re a first-time mum at least).

Breastfeeds can take a long time too – sometimes up to an hour – and your baby may feed up to 13 times a day.¹ All this new suction, pressure and saliva can result in sore nipples.

Think about lips that get sore or cracked from the wind or sun. The more you wet them by licking them, the more dry and damaged they get – so you moisturise to soothe and protect them and to help them heal. It’s the same with your nipples.

However, soreness shouldn’t last long as you and your baby should become accustomed to breastfeeding during the first couple of weeks. Treating problems promptly is essential for preventing further damage. So if your nipples crack, start bleeding, or are excruciatingly sore, speak to a lactation consultant or breastfeeding specialist as soon as you can.²

However, prevention is better than cure – so read my troubleshooting tips below.

Check your baby’s latch

The key to pain-free breastfeeding is a good latch. When your baby is latching on, aim your nipple towards the roof of his mouth. This should help him latch on to the nipple, as well as some of the areola (the circle of darker skin around the nipple) beneath it. Having both the nipple and some of the breast tissue into his mouth like this will help him feed properly.³

Get your baby’s latch checked by a lactation consultant or breastfeeding specialist in the first few days. They’ll give you advice on overcoming any problems and may suggest alternative breastfeeding positions to help you feed your baby as painlessly as possible.

Watch out for tongue-tie

Tongue-tie (ankyloglossia) affects 4 to 11% of newborns.⁴ It means the strip of skin that attaches the tongue to the bottom of the mouth, called the lingual frenulum, is too short. A tongue-tied baby may not be able to open his mouth wide enough to take in plenty of your breast when he feeds, and his tongue probably won’t cover his lower gum while he sucks. The result can be sore nipples for you and frustration for him.

A healthcare professional, lactation consultant or breastfeeding specialist needs to assess your baby to confirm a tongue-tie. It can be treated with a simple procedure called a tongue-tie division if necessary. Carried out by a healthcare professional, this doesn’t usually require anaesthetic and may help resolve feeding problems immediately.⁵

There is a similar, but rarer, condition called a lip-tie, where the frenulum attaching the upper lip to the top gum is too short. Tongue-ties and lip-ties aren’t always picked up in neonatal checks, so if you think one of these could be causing your nipple pain, seek advice quickly.⁴

Breastfeeding nipple care tips

• Only wash your breasts with water when you bath or shower. The little bumps (Montgomery glands) on your areolae produce an oil that moisturises and protects your nipples. Soaps and shower gels can strip this natural oil, causing dryness and irritation.⁶
• Air-dry your nipples or dab them gently with a towel. Women used to be told to rub their nipples to toughen them up, but this isn’t advised any more – thank goodness!
• There’s no need to clean the breast or nipples before breastfeeding. In fact, bacteria from the surface of your breast can help develop your baby’s gut microbiome.⁷
• Fresh breast milk can help heal damaged nipples,⁸ so try massaging a few drops into them before and after feeds.
• Change nursing pads frequently if they become damp to reduce the risk of bacterial or fungal infections, including thrush. ⁶
• Avoid increasing the gap between breastfeeds to ‘rest’ your nipples. Your baby needs to feed on demand to stay healthy and grow well. Remember, frequent feeding builds and maintains your supply, so keep feeding through any soreness.⁹

Useful nipple care products

• Nipple cream made from ultra-pure lanolin – a natural product obtained from sheep’s wool. This moisturises and supports healing. It’s harmless for your baby, so there’s no need to wash off lanolin before breastfeeding.
• Hydrogel pads can be placed on sore nipples to offer instant breastfeeding pain relief, as well as creating ideal conditions for healing. You can even keep them in the fridge for cooling comfort.
• Breast shells fit inside your bra. They’re great for stopping clothing rubbing against sore nipples, and have holes in so air can still get to your nipples to help them heal.
• Nursing bras made from either a breathable material like cotton, or a fabric that dries quickly and wicks excess moisture away from damaged nipples.
• Nipple shields are silicone covers that fit over your nipples, with small holes for your breast milk to flow through as you breastfeed. They protect the skin underneath and can give a baby with a poor latch something firmer to attach to. In general nipple shields should be considered a short-term solution. If problems or pain occur, consult your lactation consultant or breastfeeding specialist.

When to seek medical help

Once your baby and your nipples are used to breastfeeding, it’s true it shouldn’t hurt. It’s worth reiterating that the number one cause of sore nipples is a poor latch. If one breastfeeding expert hasn’t been able to resolve your nipple pain, try another, and another if necessary.

If your nipple pain persists or you notice unusual symptoms, see a lactation consultant or breastfeeding specialist. White spots or flakiness on your nipples could be thrush, whitish or blueish nipples could be caused by a circulatory disorder such as Raynaud’s disease (vasospasm), and pus or hot redness are signs of infection. ²

References

1 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3):e387-395.

2 Berens P et al. Academy of Breastfeeding Medicine. ABM Clinical Protocol# 26: Persistent pain with breastfeeding. Breastfeeding Medicine. 2016;11(2):46-53.

3 Cadwell K. Latching‐On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women’s Health. 2007;52(6):638-42.

4 Segal LM et al. Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review. Canadian Family Physician. 2007;53(6):1027-1033.

5 O'Shea JE  et al. Frenotomy for tongue‐tie in newborn infants. The Cochrane Library. 2017.

6 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe und Frauenheilkunde. 2013;73(12):1202-1208.

7 Pannaraj PS et al. Association between breast milk bacterial communities and establishment and development of the infant gut microbiome. JAMA pediatrics. 2017;171(7):647-654.

8 Mohammadzadeh A et al. The effect of breast milk and lanolin on sore nipples. Saudi medical journal. 2005;26(8):1231-1234.

9 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet, Gynecol, & Neonatal Nurs. 2012;41(1):114-121.

Nursing nipple care | Breast Care

Breastfeeding is good for you and your baby, but it can be a real challenge for the nipples. Check out our tips and tricks to help reduce the pain.

Share this information

Sioned Hilton, health visitor, neonatal nurse and lactation consultant:
A mother of three, Sioned Hilton has been supporting families with newborns and young children for over 30 years. She provides advice on breastfeeding and pumping, both in clinics and at home. In addition, Schoned writes articles for parenting magazines, attends conferences, and conducts seminars for attending physicians.

New mothers often hear: "Breastfeeding doesn't have to be painful." However, in the early days, many are faced with the opposite.

In most women during pregnancy, the nipples enlarge and become more sensitive. When a newborn baby begins to suckle, it creates a certain pressure, and this is a completely new and unfamiliar sensation for a woman (at least for a first-time mother).

Feedings can be prolonged for a long time, sometimes up to an hour, and the child may ask to be breastfed up to 13 times a day. ¹ This sucking, pressure and saliva of the baby can cause sore nipples.

Remember how your lips crack in the wind and sun. The more often you lick them, the more they will dry and become inflamed. Therefore, lips require good hydration to soften, protect and speed up the healing of cracks. The same thing happens with nipples.

However, sore nipples usually don't last more than a couple of weeks and go away as your baby and your breasts get used to breastfeeding. It is important to start nipple care as early as possible to prevent the situation from worsening. Therefore, if your nipples become very inflamed, crack or bleed, contact your doctor as soon as possible. ²

Prevention is better than cure, so check out our tips.

Check your baby's latch-on

Correct latch is the key to pain-free breastfeeding. When putting the baby to the breast, point the nipple towards his palate. This will allow him to grab the nipple and the part of the areola (the darker skin around the nipple) underneath. When the nipple and part of the breast is in the baby's mouth, feeding is taking place correctly. ³

For the first few days, see a lactation consultant or specialist to check for proper latch. He will be able to give you advice on how to solve problems and recommend other feeding positions that will make it less painful for you to feed your baby.

Check tongue tie

Tongue tie (ankyloglossia) occurs in 4-11% of
newborns. ⁴ At the same time, the strip of skin that attaches the tongue to the bottom of the mouth - the so-called frenulum - is too short. A child with a shortened frenulum will not be able to open his mouth wide enough to latch onto the breast well, and his tongue will not cover the lower gum when sucking. As a result, the baby will be nervous, and your nipples may become inflamed.

The doctor or lactation consultant must examine the baby to make this diagnosis. The problem of a shortened bridle is solved by a simple undercutting procedure. It is performed by a doctor, and is usually done without blood and does not require anesthesia. Cutting the bridle allows you to restore the normal feeding mechanism almost instantly. ⁵

Less common in children is a short frenulum of the upper lip. In this case, it is necessary to dissect the skin that connects the upper lip to the gum. A shortened frenum of the tongue or upper lip in a newborn is not always detected during the examination conducted immediately after birth, so if you think that this is what is causing your nipples pain, seek medical advice as soon as possible. ⁴

Breastfeeding Tips

• Wash your breasts with water only when you shower or bathe. Small bumps on the areola (Montgomery's glands) secrete oil that moisturizes and protects your nipples. Soaps and shower gels can strip away this natural defense, causing dryness and irritation. ⁶
• Pat the nipples gently with a soft towel or simply let them air dry. In the past, women were often advised to rub their nipples to make them stiffer, but thankfully, such advice is a thing of the past!
• Do not wash breasts or nipples before feeding. The bacteria found on the surface of the breast actually help the baby's gut microflora to develop. ⁷
• Fresh breast milk helps to heal cracked nipples, ⁸ so rub a few drops of milk into them before and after feeding.
• Change your bra pads often if they get wet. This will reduce the risk of bacterial and fungal infections, including thrush. ⁶
• It is not necessary to increase the intervals between feedings to give the nipples a "rest". For a baby to be healthy and grow well, it needs to be fed on demand. Remember, frequent feeding stimulates and maintains milk production, so keep feeding despite the pain. ⁹

Healthy teat care products

• Pure lanolin teat cleaner, a natural product derived from sheep's wool. It moisturizes and promotes healing of the nipples. This cream is safe for the baby, so it does not need to be washed off before feeding.
• Hydrogel Pads* can be applied to sore nipples to relieve pain while feeding and help promote healing. They can even be stored in the refrigerator to enhance the soothing cooling effect.
• Breast pads* fit into the bra. They help prevent nipple irritation from clothing and have air holes to help nipples heal.
• Nursing Bras** are made from a breathable material such as cotton or a special fabric that dries quickly and wicks moisture away from sore nipples.
• Nursing pads* are special silicone pads that fit over the nipples. They have small holes through which milk flows when you are breastfeeding. The pads help protect the skin underneath and help the baby to better latch on to the nipple by making the nipple stiffer. Do not use nursing pads for a long time. If you have problems or pain, contact your healthcare professional or lactation consultant.

When to Seek Medical Care

The soreness should go away as your nipples and baby get used to breastfeeding. It is worth repeating that the main cause of sore nipples is improper grip. If your lactation consultant has not been able to resolve your pain while feeding, see another specialist and a third if necessary.

If nipple pain persists or if you notice unusual symptoms, talk to your doctor. The appearance of white spots or flakes on the nipples may be a sign of thrush, whitish or bluish nipples may indicate a circulation disorder such as Raynaud's disease (vasospasm), and pus and redness indicate an infection. ²

Literature

1 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

2 Berens P et al. Academy of Breastfeeding Medicine. ABM Clinical Protocol#26: Persistent pain with breastfeeding. Breastfeeding Medicine. 2016;11(2):46-53. - Behrens, P. et al., Academy of Breastfeeding Medicine, AVM Clinical Protocol #26: Persistence of Breastfeeding Pain. Brestfeed Med (Breastfeeding Medicine). 2016;11(2):46-53.

3 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women's Health. 2007;52(6):638-42. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding. " F Midwifery Women Health. 2007;52(6):638-642.

4 Segal LM et al. Prevalence, diagnosis, and treatment of ankyloglossia: methodological review. Canadian Family Physician. 2007;53(6):1027-1033. - Segal L.M. et al., Incidence, Diagnosis, and Treatment of Ankyloglossia: A Methodological Review. Canadian Family Physic. 2007;53(6):1027-1033.

5 O'Shea JE et al. Frenotomy for tongue - tie in newborn infants. The Cochrane Library. 2017. - O'Shea J.I. et al., "Dissection of the frenulum in the newborn", The Cochrane Labrery (Cochrane Library), 2017.

6 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe und Frauenheilkunde. 2013;73(12):1202-1208. - Jacobs A. et al., "Recommendations S -3 for the treatment of inflammatory diseases of the breast during breastfeeding. Geburtskhilfe und Frauenheilkünde. milk bacterial communities and establishment and development of the infant gut microbiome JAMA pediatrics 2017;171(7):647-654 - P. S. Pannaraj et al., "Bacterial communities in breast milk and their association with the occurrence and development of the neonatal gut microbiome." JAMA pediatric. 2017;171(7):647-654.

8 Mohammadzadeh A et al. The effect of breast milk and lanolin on sore nipples. Saudi medical journal. 2005;26(8):1231-1234. — Mohammedzade A. et al., "Effects of breast milk and lanolin on sore nipples." Saudi Medical Journal. 2005;26(8):1231-1234.

9 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

Read instructions before use. Consult a specialist about possible contraindications.

* RC № № ФСЗ 2010/07352 dated 19.07.2010

** RU No. FZZ 2009/05592 dated 11/25/2009

Nipple fissure: Methods of treatment - ProMedicina Ufa

nipple integrity crack. It is manifested by a sharp soreness with irradiation to the shoulder blade when feeding a child. It can be complicated by infection of wounds, the development of candidiasis on the nipple, mastitis. If cracks become infected, there is a risk of infection of the child during feeding.