cracked & bleeding nipples

I have recently had an influx of questions and concerns regarding cracked, bleeding nipples when breastfeeding. It is largely believed that nipples tend to crack / bleed in the early days due to an incorrect latch. While this is definitely a reality, it is not the only cause. Cracked nipples may also come about due to prolonged sucking (even when latched correctly), incorrect use of a breast pump, thrush, slight nipple inversion or excessively dry skin. For some women, their nipples become tender or lightly cracked simply because of hormonal changes after birth. Added to all of this, your breasts are doing something they have never done before and so a little ‘breaking in’ is completely normal.

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How to manage cracked nipples:

It is important that you have your latch checked by a qualified professional to rule out and correct any issues. Your lactation consultant, midwife or nurse will also be able to check your baby’s mouth to rule out problems such as a tongue tie.

Once your baby’s latch has been checked / corrected, you can do the following:

-Wash nipples with a saline solution after each feed and allow to dry completely before applying nipple creams. You can make your own solution by mixing 1/2 teaspoon of salt in 1 cup of water. Make a new batch each day.

-Apply expressed breastmilk to the nipples and allow to air dry

-Use a high grade pure lanolin such as lansinoh or medela purelan after each feed

-Make use of an anti-bacterial cream (such as Bactroban). Use a small amount after your morning and evening feed – generally this will not need to be washed off before your next feed unless you have used a lot and there is a noticeable residue in which case you can simply wipe off with a damp cloth

-Change breast pads often. moisture from your breast pads will prolong healing as well as promote growth of bacteria.

-Change positions. Often, the placement of your baby’s tongue will affect the amount of pain that you are experiencing. If you normally feed in the cradle hold, switch to a football hold until the cracks heal up

-Place ice on the nipple before feeding as this will numb the initial pain of latching

-Give yourself a break. Express from the sore side and bottle / cup feed for a day if needed

-Avoid using soap on your nipples. Soaps can often be harsh on our skin and cause it to dry out.

-Make use of a dummy. There is little research to show that a dummy causes nipple confusion (this is more common with the use of a bottle). Most babies enjoy non-nutritive sucking and will learn very quickly that milk comes from the breast and not from the dummy. Avoid prolonged sucking after a feed and offer a dummy for comfort sucking.

Can I continue to feed my baby?

Yes, do not stop feeding your baby breastmilk! Feeding with cracked nipples is completely safe.

If the pain is unbearable, get hold of a good breast pump so that you can express and bottle / cup feed for a day to give yourself a break.

Article by breastfeeding consultant Jenna Richards