Nipples cracking pregnancy

Nipple fissures: Causes, symptoms, and treatment

Nipple fissures are painful cracks on the skin of the nipple and areola. Nipple fissures are common during pregnancy and breast-feeding, but may be caused by friction in some athletes.

People who experience nipple fissures should treat them with care, as it is possible for the area to become infected.

Home treatments can provide relief in many cases, though there are times when it is important to see a doctor. Preventing nipple fissures before they happen is the best way to avoid symptoms and complications.

Fast facts on nipple fissure:

Nipple fissures are common during pregnancy and breast-feeding.
Knowing what causes them is the best way to prevent them from happening again.
Antiseptic creams may help prevent infection while the nipples heal.

There are a variety of reasons why nipple fissures occur:

Pregnancy and breast-feeding

Share on PinterestNipple fissures may appear if a woman has problems with breastfeeding.

Hormonal changes during pregnancy can cause the breasts to become more full. The extra fullness can stretch the skin and irritate the areola and nipple, which may lead to fissures.

Women who have problems with breast-feeding may also develop nipple fissures. If the baby does not latch on correctly, they may put too much force on the sensitive skin of the nipple and areola. This could cause unnecessary irritation.

Nipple fissures may also be a symptom of thrush, which is a fungal infection.

While nipple fissures are often dry cracks, too much moisture may also be responsible for these symptoms. This may be due to breast-feeding for too long or the nipples being damp for an extended period, either from leakage, wet nursing pads, or too much ointment.

While nipple fissures tend to be prevalent in pregnant and breast-feeding women, the cracks can occur in anyone.

Friction

Too much friction may also irritate the nipple area. For example, long-distance runners might develop what is known as jogger’s nipple or runner’s nipple.

Friction from the cloth of a loose shirt or a poorly fitting bra can rub against the sensitive nipple skin, causing chafing, cracks, and even bleeding. Nipple fissures caused by friction may also occur in surfers and bodyboarders due to the board and seawater rubbing against the nipples while paddling.

Certain fabrics may be more irritating than others, with synthetic fibers, such as nylon, often causing more damage.

Allergic reaction

Nipple fissures may also be due to an allergic reaction to something touching the skin. These allergens can be chemicals or fragrances in products such as:

laundry detergent
fabric softener
shampoo or conditioner
soap or shower gel
lotion or moisturizer
perfume

If irritation and nipple fissures occur after applying a product, it is possible that the person’s skin is sensitive to the chemicals or fragrances in that product. Dermatologists may be able to recommend replacements to prevent the symptoms from coming back.

Depending on the cause, nipple fissures can develop on one or both nipples. Symptoms can vary from person-to-person, but the trademark symptom is cracked, painful skin on the nipple or areola. It may also be accompanied by:

chapped, dry skin
open cracks that may ooze or bleed
redness
soreness
crusty or flaky skin
scabs forming in the area

Share on PinterestStudies suggest that peppermint oil may help to keep treat nipple fissures.

Many people find that keeping the affected nipple and surrounding skin slightly moist with a natural oil or moisturizer is an essential first step to treatment.

A study posted to the Journal of Caring Sciences found that lanolin, peppermint oil, and dexpanthenol creams all had a similar effect on nipple trauma in breast-feeding women. Some people are concerned, however, that the use of any nipple cream may interfere with the natural environment where newborns establish breast-feeding.

It is important to remember that too much moisture may make symptoms worse. Women who are breast-feeding should avoid non-breathable bra pads, as they can hold too much moisture against the nipple.

During pregnancy, the glands surrounding the nipples secrete a natural oil that lubricates and discourages bacteria. When washing this area, women should use only clean water that does not strip away this natural protection.

Breast-feeding women may find relief from bathing their nipples in warm water and applying warm compresses to help soothe any irritation after the baby has fed. Expressing some milk and rubbing it into the nipples before each feeding or pumping may also soothe irritation.

Some people may find similar relief by applying diluted peppermint oil or peppermint water to the affected nipples between feeding.

Breast-feeding women with nipple fissures may also be able to avoid further complications by encouraging the baby to latch onto the breast with a full mouth, alternating breasts at each feed, or using a nipple shell between feeds to allow air to circulate to the nipple.

Using a nipple shield during breast-feeding may keep the nipple too moist, which might make symptoms worse.

Athletes can often help the fissures heal by avoiding loose, rough, or scratchy shirts and covering the nipples with soft gauze or waterproof bandages while active.

If symptoms are left untreated, nipple fissures can lead to more serious complications, such as inflammation or infections. Breast infections may cause abscesses to form, which could require antibiotics, laceration, and drainage.

Nipple thrush is a possible complication in breast-feeding women. Babies with thrush may pass germs from their mouth into the breast milk. The Candida yeast that causes thrush can thrive in the warm, dark environment within the milk ducts, possibly leading to an infection. Many women find that cleaning the nipple in warm water after feeding can help remove the excess milk that may be home to germs.

While most people can treat nipple fissures successfully at home, there are occasions when it is better to see a doctor. A doctor should diagnose symptoms that get worse or do not go away with treatment.

A doctor should also check out very painful or irritated nipples that make a person’s daily life difficult. Anyone who has signs of infection should visit their doctor for proper treatment. Signs of infection include redness, swelling, warmth, and tenderness in the nipple and surrounding skin.

Women who have developed nipple fissures through breast-feeding may want to talk to a doctor or pediatrician for support. A professional may offer breast-feeding tips or refer the woman to a lactation coach.

There are several ways that a person can reduce the chances of developing nipple fissure:

Sports

Share on PinterestWearing rash guards when surfing and bodyboarding is recommended to avoid chafing.

If nipple fissure is caused by friction during sports, a person could try changing the type of fabric they wear or place waterproof bandages over the nipples to help reduce friction and avoid fissures.

Some runners, surfers, and other athletes may find that applying an anti-chafing balm to their nipples before they exercise can help reduce friction.

Many surfers and bodyboarders simply wear rash guards or wetsuits to avoid irritation.

Tight fitting clothing that helps wick sweat away from the body may help some. Female athletes should be sure to wear a well-fitting sports bra to support the breasts and avoid unnecessary friction.

Breast-feeding

To prevent or reduce the chances of developing nipple fissures, a breast-feeding woman should ensure that she does certain things each time the baby latches on.

While breast-feeding may cause discomfort at first, it is important for both mother and baby to be comfortable during breast-feeding. If the baby has not latched on correctly or if feeding is causing pain, it is best to reposition them. Both mother and child should be relaxed, and the baby should not have to turn their head or body while feeding, as it could pull at the nipple and irritate it further.

Helping the baby latch onto the breast accurately during feeding can also help prevent irritation. The baby should take the entire nipple and part of the areola into their mouth during feeding. Having a full mouth helps keep them from biting down too hard on one part of the nipple, which could irritate the skin.

An allergic reaction

If nipple fissure is caused by an allergic reaction to something, then identifying the irritant and avoiding it however possible may prevent symptoms developing. A person might choose to visit a dermatologist who can carry out some tests to identify potential allergens.

Nipple fissures can be a source of pain and discomfort, but treating them is usually straightforward. Breast-feeding women who have nipple fissures may need to change their feeding habits to continue feeding a baby. In some situations, prevention may be the best option.

Anyone with symptoms that get worse or do not improve should see a doctor to avoid complications.

Nipple fissures: Causes, symptoms, and treatment

Nipple fissures are painful cracks on the skin of the nipple and areola. Nipple fissures are common during pregnancy and breast-feeding, but may be caused by friction in some athletes.

People who experience nipple fissures should treat them with care, as it is possible for the area to become infected.

Fast facts on nipple fissure:

Nipple fissures are common during pregnancy and breast-feeding.
Knowing what causes them is the best way to prevent them from happening again.
Antiseptic creams may help prevent infection while the nipples heal.

There are a variety of reasons why nipple fissures occur:

Pregnancy and breast-feeding

Share on PinterestNipple fissures may appear if a woman has problems with breastfeeding.

Hormonal changes during pregnancy can cause the breasts to become more full. The extra fullness can stretch the skin and irritate the areola and nipple, which may lead to fissures.

Nipple fissures may also be a symptom of thrush, which is a fungal infection.

While nipple fissures tend to be prevalent in pregnant and breast-feeding women, the cracks can occur in anyone.

Friction

Too much friction may also irritate the nipple area. For example, long-distance runners might develop what is known as jogger’s nipple or runner’s nipple.

Certain fabrics may be more irritating than others, with synthetic fibers, such as nylon, often causing more damage.

Allergic reaction

Nipple fissures may also be due to an allergic reaction to something touching the skin. These allergens can be chemicals or fragrances in products such as:

laundry detergent
fabric softener
shampoo or conditioner
soap or shower gel
lotion or moisturizer
perfume

chapped, dry skin
open cracks that may ooze or bleed
redness
soreness
crusty or flaky skin
scabs forming in the area

Share on PinterestStudies suggest that peppermint oil may help to keep treat nipple fissures.

Many people find that keeping the affected nipple and surrounding skin slightly moist with a natural oil or moisturizer is an essential first step to treatment.

It is important to remember that too much moisture may make symptoms worse. Women who are breast-feeding should avoid non-breathable bra pads, as they can hold too much moisture against the nipple.

Some people may find similar relief by applying diluted peppermint oil or peppermint water to the affected nipples between feeding.

Using a nipple shield during breast-feeding may keep the nipple too moist, which might make symptoms worse.

Athletes can often help the fissures heal by avoiding loose, rough, or scratchy shirts and covering the nipples with soft gauze or waterproof bandages while active.

There are several ways that a person can reduce the chances of developing nipple fissure:

Sports

Share on PinterestWearing rash guards when surfing and bodyboarding is recommended to avoid chafing.

Some runners, surfers, and other athletes may find that applying an anti-chafing balm to their nipples before they exercise can help reduce friction.

Many surfers and bodyboarders simply wear rash guards or wetsuits to avoid irritation.

Tight fitting clothing that helps wick sweat away from the body may help some. Female athletes should be sure to wear a well-fitting sports bra to support the breasts and avoid unnecessary friction.

Breast-feeding

To prevent or reduce the chances of developing nipple fissures, a breast-feeding woman should ensure that she does certain things each time the baby latches on.

An allergic reaction

Anyone with symptoms that get worse or do not improve should see a doctor to avoid complications.

Breast changes from the beginning of pregnancy to the end of breastfeeding

Medela's experts explain what changes occur in the breast from the beginning of pregnancy to the end of breastfeeding, and share tips for taking care of your breasts throughout this period.

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From the moment of conception, your body begins to prepare for the birth of your baby. This applies not only to the uterus - the anatomy of the breast also changes radically. This article will tell you what to expect in each trimester, during and after breastfeeding.

First trimester breast changes

Early in pregnancy, many women notice changes in their breasts. Moreover, often they become the first signs of pregnancy. Fluctuations in hormone levels and changes in the structure of the mammary glands can cause increased sensitivity and soreness of the nipples and breasts as early as the third or fourth week. For some pregnant women, breast tenderness persists until childbirth, but for most it goes away after the first trimester.

“Sometimes during pregnancy, breasts grow very quickly in the first weeks, and sometimes their size increases gradually,” says Dr. Jacqueline Kent, a leading lactation specialist at the University of Western Australia. “All women are different. For some, breast size may not change much until childbirth or even after them. In general, we can say that by the time the milk arrives, the breast will most likely become one and a half times larger than before pregnancy! ¹

As soon as your regular bras start to feel tight (usually around 12 weeks), it's time to buy a maternity bra. The most comfortable, according to many women, are seamless models with wide straps made of soft, breathable fabric. It is best to avoid underwired bras as they can put pressure on the developing milk ducts.

It is important to take your measurements correctly in order to find the right bra with a good fit. Take measurements every couple of months, as you may need a different size bra as your baby grows and your breasts get bigger.

Breast changes in the second trimester

From about the 15th week of pregnancy, newly formed cells that produce milk are activated in the breast, and by about the 22nd week, production begins. ¹ But don't worry - most of this milk will be absorbed by the body without going out, as pregnancy hormones prevent it from being overproduced or excreted.

“During the second trimester, you may notice that the nipples and areolas (the areas of skin around the nipples) become darker and larger,” says Dr. Daniel Prime, Medical Research Associate at Medela. tubercles - the so-called glands of Montgomery. They secrete oil that moisturizes the nipples and will protect them from inflammation and infection when you start to feed. Scientists believe that the smell of this fat is similar to the smell of amniotic fluid and helps the newborn baby find the nipple. ” ²

Do not use harsh soap for breast hygiene and do not rub hard with a towel as this can damage this natural lubricant. Just wash your breasts with warm water and pat dry. And if someone tells you to pinch or rub your nipples to prepare them for breastfeeding, don't listen to them!

If you have flat or inverted nipples, your pregnancy is over 32 weeks, and your pregnancy is normal, you can try inserting special nipple formers* into your bra in consultation with your doctor. They help to gently pull out the nipples so that it is easier for the newborn to grasp them. Consult your healthcare professional or read our article on flat and inverted nipples to learn more.

If breast size increases dramatically during pregnancy, breast skin may itch and stretch marks may appear on it. A good moisturizer can help soothe itching. The appearance of stretch marks usually depends on genetics and skin type. If you have a predisposition to stretch marks, it is unlikely that you will be able to prevent them, but, fortunately, over time they will become lighter and less noticeable.

Breast changes in the third trimester

In the last trimester, you may again experience soreness and heaviness in your chest. A sleep bra will keep you comfortable at night, while a supportive sports bra will help you avoid soreness and ligament damage during exercise.

Don't forget to buy a pair of nursing bras one month before your baby is born. If possible, consult a specialist in the store or study the online guide to select the appropriate model and size. Every woman is different, but usually cups of a nursing bra are chosen one or two sizes larger than before pregnancy. The underbust girth may also increase as the ribcage expands to provide enough room for the baby. The sales assistant should choose the size of your bra, taking into account the appearance of milk after childbirth. Models with fasteners that can be unfastened with one hand make it easier to attach the baby to the breast.

Surprising but true: milk appears in the breast even before the baby is born. This is why your nipples may start to produce some colostrum (the first breast milk), which will be quite thick and sticky. Sometimes this happens as early as 14 weeks, but more often it still happens in late pregnancy. To avoid the appearance of stains and smudges on clothes, you can use special bra pads.

“If you have diabetes or have been diagnosed with gestational diabetes, your doctor may tell you to express some colostrum by hand and freeze it. A recent study showed that after the 36th week it is quite safe if the pregnancy does not have other complications, ³, says Dr. Prime, “Storing colostrum can come in handy because babies with diabetic mothers are at higher risk of hypoglycemia (low blood sugar), and frequent colostrum feeding is the best remedy. . However, be prepared for the fact that there will be very little colostrum. You may only be able to express a few drops at first, and that’s perfectly fine.”

What happens to the breast after childbirth

Approximately two to four days after the baby is born (sometimes later if there was a caesarean section or a traumatic delivery), you will feel your breasts becoming heavier and firmer - this means that the milk has come. ⁴

“This breast fullness is not only due to excessive milk production – there is also an increase in the amount of blood circulating around the breast and the volume of lymphatic fluid,” explains Dr. Prime, “All this is the result of a gradual decrease in pregnancy hormone levels that began after the birth of a child and which allows the hormones responsible for the production of milk to enter into work.

During this period, you may experience soreness and discomfort in your breasts, a condition called breast swelling. This is quite common and usually resolves after a few days, during which time breastfeeding must continue. Read on for our tips on how to relieve swelling and discomfort, and if the problem persists, see a lactation consultant or healthcare provider.

What happens to the breast during lactation

For about the first three months of breastfeeding, your breasts are likely to fill up a lot before feeding. Over time, you may notice that your breasts become less full, but this does not mean at all that your milk production has decreased. If you are breastfeeding your baby exclusively and on demand, and at the same time he is growing well, then everything is in order with the amount of milk.

“Be prepared for the fact that after six months of breastfeeding, your breast size will begin to decrease,” Dr. Kent explains, “This is not a sign that your body is producing less milk. Most likely, the amount of adipose tissue in the breast simply decreased. By the time your baby is 15 months old, your breasts may be back to their pre-pregnancy size, but not smaller. However, whether you continue breastfeeding or not, you may still produce 100 to 300 ml of milk per day.”

This may be due to the start of more efficient milk production after six months of breastfeeding, which, according to Dr. Kent's research, may be the result of redistribution of breast tissue. ⁵

How your breasts change after you stop breastfeeding

When you finally stop breastfeeding—be it after three weeks, three months, or three years—the breast changes associated with lactation disappear. “After the complete cessation of breastfeeding, the breasts, as a rule, return to the size that they were before pregnancy. This usually happens in about three months, and for someone else while breastfeeding,” Dr. Kent explains, “If you get pregnant again, the whole process starts all over again.”

Literature

1 Cox DB et al. Breast growth and the urinary excretion of lactose during human pregnancy and early lactation: endocrine relationship. Exp Physiol . 1999;84(2):421-434. - Cox D.B. et al., "Breast growth and urinary lactose excretion during pregnancy and early lactation: an endocrine relationship." Exp Physiol. 1999;84(2):421-434.

2 Doucet S et al. The secretion of areolar (Montgomery’s) glands from lactating women elicits selective, unconditional responses in neonates.PLoS One . 2009;4(10): e 7579. - Doucet S. et al., "Papillary gland secretion (Montgomery's glands) in lactating women induces a selective unconditioned response in the newborn. " PLOS One. 2009;4(10):e7579.

3 Forster DA et al. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomized controlled trial. Lancet. 2017;389(10085):2204-2213. - Forster D.A. et al., "Women with Gestational Diabetes are Recommended to Express Milk Late in Pregnancy (Diabetes and Antenatal Pumping [ DAME ]): A Multicenter, Open, Randomized, Controlled Trial. Lancet (Lancet). 2017;389(10085):2204- 2213.

4 Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals, Geneva : World Health Organization ; 2009. AVAILABLE FROM : https://www.ncbi.nlm.nih.gov/NBKS/NBK148965/ - "POSTICION" POSTICION "POSTRIMENTS" POSTIC textbook for students of medical and related professions. Geneva: World Health Organization, 2009. Article cited: https://www.ncbi.nlm.nih.gov/books/NBK148965/

5 Kent JC et al. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999;84(2):435-447. - Kent J.S. et al., "Amount and production of breast milk during long-term lactation in women". Ex Physiol. 1999;84(2):435-447.

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

* RC № ФСЗ 2010/07352 dated 07/19/2010

Cracks in the nipples | Medela

Amir, L.H. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med 9, 239–243 (2014). - Amir L.Kh., "AVM Clinical Protocol #4: Mastitis", revised March 2014 Brestfeed Med 9 (Breastfeeding Medicine) 239–243 (2014).

Jacobs, A. et al. S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period: AWMF Guidelines, Registry No. 015/071 (short version) AWMF Leitlinien-Register Nr. 015/071 (Kurzfassung). Geburtshilfe Frauenheilkd . 73, 1202–1208 (2013). - Jacobs, A. et al., "Guideline S -3 for the management of inflammatory breast disease during breastfeeding: AWMF Guideline , registration number 015/071 (short version)" AWMF

80078 Leitlinjen- Registration number 015/071 (Kurzfassung).

Geburtschilde Frauenheilkd. 73, 1202–1208 (2013).

American Academy of Pediatrics and The American College of Obstetricians and Gynecologists. Breastfeeding handbook for physicians 2006). - American Academy of Pediatrics and American College of Obstetrics and Gynecology. "Medical Guide to Breastfeeding", 2006.

Lawrence , R . A . & Lawrence , R . M . Breastfeeding : a guide for the medical profession ( Elsevier Mosby , Maryland Heights , MO , 2011). - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." (Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2011.)

McClellan, H.L. et al. Infants of mothers with persistent nipple pain exert strong sucking vacuums. Paediatica 97, 1205–1209 (2008). — McClellan H.L. et al., "Babies of mothers suffering from persistent nipple pain create extremely high sucking vacuums." Pediatrics 97, 1205–1209 (2008).

McClellan, H.L. et al. Breastfeeding frequency, milk volume, and duration in mother-infant dyads with persistent nipple pain.

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