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Sore Nipples During Breastfeeding: Causes And Treatment

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August 1st – 7th is observed as World Breastfeeding Week every year with the aim to encourage breastfeeding and improve the health of babies all over the world. 

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months, starting from one hour after child birth[1]. Thereafter, it should be supplemented with nutritious complementary foods for two years. However, only 35% of babies across the world are breastfeed until five months even though 98% of women worldwide are physiologically able to breastfeed[2]. And a common reason for women to stop breastfeeding during the initial days is cracked and sore nipples.

In this article, let’s know in detail about the common causes of sore nipples and how to deal with it to ensure proper breastfeeding and help reap its health benefits for both the kid and the mother.

Causes Of Sore Nipples During Breastfeeding

Sore nipples are a common problem lactating women and not just first-time mothers. In fact, it is seen to affect women even after a month of childbirth. It is a painful condition but what is more important is the fact that it can affect the mood, sleep, general activity as well as bonding between a mother and baby. Some of the common reasons that lead to sore nipples include:

Improper latching: Every mother needs to know that learning and attaining a perfect latch position is a slow process. And it is only through trial and error that you master the art. Improper latching is when your baby fails to suck onto your breast the right way, which can cause sore nipples and affect the breastfeeding process. If the suckling action causes nipple friction or if there is strong suction by the baby, even then there are high chances of painful nipples.

Long breastfeeding sessions: While it is important to ensure that your baby is full and comply with the demands of your child, remember that suckling from one breast for a long time can cause the breast to become sore. If your baby doesn’t feel full and is suckling from one breast for a long time, it is wise to break the latch and offer the other breast to ease the pressure on just one breast.

Flat or inverted nipples: If you have flat or inverted nipples, then it becomes difficult for the baby to get a proper latch. This, in turn, can cause suboptimal positioning and attachment of the infant leading to nipple pain. As the baby learns to latch,  it is quite possible that she bites or nibbles the breast which can lead to cracked or sore nipples.

Infections: Infections in and around the breast and nipples can also cause nipple pain. These include psoriasis, dermatitis, bacterial infection caused by Candida albicans, and Staphylococcus aureus and viral infections such as Herpes simplex virus. Mastitis, which is an inflammation of the breast tissue, is also known to cause sore nipples during breastfeeding.

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Tips To Deal With Sore Nipples

The treatment for sore nipples is dependant on the cause of it. Here are some of the common ways to deal with it that range from home remedies to medications.

Correct positioning and latching: It does take time to learn the right way to latch but once you get a hold of it, it can prevent nipple pain. When performed within the first week of childbirth for a longer duration of breastfeeding, the chances of sore nipples was found to be less. Studies claimed that improvement in latch resolved breast pain in 65% of cases[3].

Nipple shields: These are suggested for short-term use and mostly in premature infants. Nipple shields also work for women with inverted nipples which help in keeping the infant at the breast and limit nipple pain. Although it is suggested that the suction is less strong when a nipple shield is used, however, there is no clear research to support the claim. Remember that these are not advised for long-term use, so consult your doctor to know more about its use. 

Medications: If the nipple pain is due to an infection, then treating the underlying cause of the infection helps to treat nipple pain. For example, nipple pain due to bacterial infection can be treated with antibiotics whereas, for a Candida infection, the use of antifungal medication is recommended. Use of topical steroids might be recommended to fight dermatitis and psoriasis and thus, nipple pain. To know the exact cause of the infection and the right treatment, visit your doctor. Avoid self-medication as it can not only worsen the condition but can also affect the kid (if the chemicals are passed through breast milk).

Home remedies: There are several home remedies which are known to ease sore nipples and help in breastfeeding. Application of tea bags soaked in slightly hot water eases pain, improves blood circulation and heals the breast tissue[4]. Tea contains tannins, which act as astringents (which constricts the tissue and heals the skin). Another home remedy that works wonders is peppermint water which is prepared by soaking a few mint leaves in water overnight). When applied to the sore tissue, it causes pain relief and also fastens the healing process[5]. It prevents further nipple damage and soreness.

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Sore nipples during the initial days of breastfeeding are quite common. It is completely natural and there are ways to deal with it. Talk to your doctor to know the cause of it and ways to ease the pain and continue breastfeeding. Do not stop breastfeeding due to sore nipples but treat the cause of it because breastfeeding is essential for every child for proper growth and development. Share the article with every mom you know to spread the word and support the need for breastfeeding.

(The article is reviewed by Dr. Swati Mishra, Medical Editor)

Recommended Reads:

7 Things That You Must Be Aware Of Breastfeeding

7 Common Breastfeeding Myths!

References:

1. World Breastfeeding Week 2019. The World Health Organization (WHO). 

2. Niazi A, Rahimi VB, Soheili-Far S, et al. A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable? J Pharmacopuncture. 2018 Sep;21(3):139-150.

3. Kent JC, Ashton E, Hardwick CM, et al. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments. Int J Environ Res Public Health. 2015 Sep 29;12(10):12247-63.

4. Lavergne NA. Does application of tea bags to sore nipples while breastfeeding provide effective relief? J Obstet Gynecol Neonatal Nurs. 1997 Jan-Feb;26(1):53-8. 

5. Sayyah Melli M, Rashidi MR, Delazar A, et al. Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial. Int Breastfeed J. 2007 Apr 19;2:7.

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