You will need to work out the source of your nipple problems. The first thing to do is to check if your baby is latching on correctly. You may need to ask a health professional for assistance. They can also check your baby for problems with their lips and tongue and whether you have medical problems like dermatitis or nipple infection. The Australian Breastfeeding Association has more tips on treating sore or cracked nipples. If you need further help or are experiencing prolonged abnormal breast pain, contact your doctor, lactation consultant, breast feeding counsellor, child health nurse or Pregnancy Birth and Baby on Learn more here about the development and quality assurance of healthdirect content.
This article provides information about the causes and symptoms of nipple infection. Read more on Australian Breastfeeding Association website. Mothers are often surprised to find breastfeeding feels more awkward, complicated or painful than they were prepared for. Breastfeeding is a learned skill for mothers. Like with learning any new skill, it can take some time to get the hang of breastfeeding.
Sometimes breastfeeding feels difficult because mothers have been given traditional advice to position their babies in a way that feels uncomfortable. Uncomfortable breastfeeding positions can cause your baby to squash the nipple as they feed. Vasospasm happens when blood vessels tighten and go into spasm, so that blood does not flow normally.
Mothers with vasospasm of the nipple feel sharp pain, burning or stinging in the nipple. It is usually accompanied by sudden whitening of the nipple, followed by a colour change from red to blue. There are two main causes of nipple vasospasm. It can be a response of the nipple to trauma, if the baby is not attached to the breast well. In this case, it tends to occur following breastfeeds.
Attention to how your baby attaches can help resolve this problem. Read more on Karitane website. Read more on Sydney Children's Hospitals Network website. When establishing breastfeeding good positioning and attachment are key. Here are some tips from Tresillian to help your breastfeed your newborn.
Read more on Tresillian website. Vasospasm affects the flow of milk from the nipple and can be a painful condition for women breastfeeding.
Learn about vasospasm and how to relieve the pain. A baby who attaches well to the breast can help prevent many breastfeeding problems. The well-attached baby causes no nipple pain and drains the breast well. This helps ensure a good milk supply so the baby grows well. The duration of the healing will vary. Superficial and recent soreness may clear in a matter of hours or days. However, long-established and profound wounds may require a up to 2 or 3 weeks to be entirely resolved even after the cause of the soreness has been eliminated.
If positioning and attachment is adjusted so that pain is minimised with no new damage visible after a feed, you can continue breastfeeding. The wound will continue to heal. Supporting women with cracked nipples is such a large part of our work, it is surprising how little certainty there is on the best method of healing them. We know that adjusting positioning is crucial to avoid any further damage. An established wound that is slow to heal may be a sign of continued friction.
So, start with watching a whole feed to see whether fresh injury is happening and if so, at what stage. Watching for any changes in suckling and swallowing will give further clues. Usually a more comfortable position can be found, but the wound may have been established for some weeks before we become involved. In these circumstances we can offer support while working towards comfortable feeding.
Many women with cracked nipples want to know if there is anything they can put on the wound to speed up healing. A typical response might have been to suggest air drying or expressed breastmilk EBM. However, when looking at the research we have a dilemma. Nor is there any scientific evidence to support the use of expressed breastmilk or colostrum on the nipples after feeding. All books agree that no product is a substitute for finding and correcting the cause of soreness. The aim of this article is to help women achieve pain free effective breastfeeding.
There is a move towards using moist wound healing for cracked nipples. At this point it is worth distinguishing between sore unbroken skin or cracked wounded, broken skin nipples. Many of the text books discuss sore, rather than cracked nipples or include sore and cracked nipples together see above.
This is reflected in the design of many research studies into moist wound healing, so it is perhaps not surprising that results are often inconclusive. Yet sore nipples should be able to heal without creams, providing help is given with positioning to prevent a crack developing. Any study which suggests that using a moisturiser would help women with sore nipples should compare subsequent rates of cracked nipples in each group, as well as levels of pain. There appears to be no such study.
It seems probable that the main use of moisturisers or other forms of skin care should be when the skin is broken as a result of nipple trauma, especially when prevented from healing by repeated damage. Renfrew, Woolridge, Ross McGill agree that no controlled studies of adequate size have been published to date.
Compare this with general health care, where the principles of moist wound healing are well established. The importance of a moist environment for wound healing was identified by the work of George Winter Nature , , , He compared the effect of leaving superficial wounds exposed to form a scab, with the effect of applying a vapour-permeable film dressing on a pig.
The wounds healed twice as quickly when kept humid. The dressing maintained humidity on the wound surface, allowing skin cells to slide across the surface of the wound. With a scab, the cells had to go deeper under all the dry crust and dead skin to find a moist layer ref 6, p This moisture prevents a hard scab forming.
When applying this to cracked nipples, a softer wound has an extra advantage. There is less risk of further damage happening during breastfeeding as there is no hard scab to pull off during a feed, taking the new skin cells lying underneath with it.
Keeping the wound moist also reduces pain by keeping air from drying out the exposed nerve endings then more pain as it rehydrates ref 6, p We are, however, unaware of any study that has looked at this specifically.
Normally a new wound heals when the edges close together. An established wound heals from the base upwards, with the new skin growing over the edges, so they look smooth — often described as a rolled edge. As these wounds look like they are healing relatively slowly, women can feel disheartened. It helps to explain this and to look for the wound getting shallower. These wounds are most likely to benefit from moist wound healing, reducing any scab formation and allowing the skin cells to glide over each other.
This is sometimes referred to as secondary wound healing, as opposed to the primary wound healing that occurs for more recent and superficial wounds. This process takes longer, and the wound is more susceptible to infection and scab formation in the meantime. Newly healed wounds are not as strong as normal skin, so can re-open if the baby slips when feeding. This is more likely to happen when the mother or baby is sleepy. Feeding lying side-on may help reduce the chance of this happening during night-time feeds.
While the wound is healing, it sometimes helps to talk about a pain scale — imagine a ruler numbered 0 to 10, with 10 being unbearable pain.
Suggest trying to drop down the scale at each feed so the mother can see a progression towards no pain at all.
Correcting the position should give her an instant drop someway down the scale but not necessarily to 0. Depending on the extent of the wound, it may take some time before she reaches 0. If pain stays the same, or increases, ask her to contact you again. Finding a comfortable feeding position however, is usually less trouble than expressing milk, which puts suction on the wound.
The table below reviews the different moist wound healing treatments available. Choosing a moisturiser is not easy. Vaseline is widely used in wound care, either directly, or as a base for other creams. Lanolin is also used as a base but concerns over allergic responses and high levels of contaminants ref 2 and 7 limit its use.
Purified lanolin is a purified anhydrous version. Unfortunately, these comments are not referenced and the standard reference book for drugs, Martindales Pharmacopoeia, makes no reference to this.
Softened paraffin is likely to stay on the surface of the skin longer than purified lanolin but this is what makes it so useful in preventing hard scab formation.
It is worth noting that white soft paraffin, or its unbleached version yellow soft paraffin, has been widely used over many years for lip care in special care baby units — if it was unsafe for ingestion why is it used directly on babies lips?
Try these five natural remedies to treat sore, cracked nipples. Then learn what you can do to prevent this problem from happening again.
There are two frequent causes of traumatized nipples: poor latch at the breast and suction trauma as a result of improper positioning. There are a number of possible reasons for incorrect positioning. Breast-feeding is a learned skill for moms and babies alike.
If a baby has a shallow latch, they may also nurse more frequently. Speak to a certified lactation consultant. They will be able to assess both your breast-feeding and latch techniques. Proper positioning is essential for preventing future trauma to your nipples. But how can you treat cracked nipples if you have them?
Smoothing freshly expressed breast milk onto cracked nipples may help them heal by offering antibacterial protection. Make sure to wash your hands before gently applying a few drops of breast milk to your nipples. Allow the milk to air-dry before covering up.
Note: If you have thrush, this remedy should be avoided. Any breast milk should be rinsed off the nipple after feeding your baby.
Yeast grows quickly in human milk. This is another readily available and inexpensive treatment option. Be sure to make a fresh supply of saline solution daily to reduce the chances of bacterial contamination. Using a lanolin ointment specifically designed for breast-feeding mothers will help promote moist wound healing. Apply to nipples after breast-feeding. Change nursing pads as soon as they become damp. Leaving the moisture against your nipples can delay healing. Also avoid nursing pads made with plastic linings.
They can obstruct airflow. Look for pads made from percent cotton.
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