You’re getting settled with your new baby at home. To say you’re exhausted might be putting it lightly.
Between the diaper changes and feedings, it’s all you can do to stuff a granola bar down for lunch, let alone take a shower or pick up the house.
You’re nursing your baby every 2-3 hours, and trying so hard since you know for a thousand and one reasons it’s best for both of you. You’ve heard endless times how beautiful and natural breastfeeding is, and pictures you’ve seen of mommies and their babies really are the epitome of that.
Except what is with this searing pain you’re experiencing when baby latches on? And why are your nipples cracking and bleeding?
No one warned you about this. Will the pain go away on its own? Are you supposed to suffer through this until that time comes?
The answer is no! Fortunately, many lactation consultants have shared (and continue to share) their knowledge so that you can hopefully heal ASAP.
Why are your nipples cracked or bleeding?
Almost all lactation consultants agree that the main cause of cracked or bleeding nipples is an improper latch. This little cheat sheet is an awesome quick tool for you to reference about proper latch. Other reasons why your nipples might be cracked or bleeding include:
- Improper use of a breast pump. If you’re one of the lucky moms to be pumping already after baby is born, definitely take the time to be sure you are using the pump correctly. Check the flanges your breast pump came with. When pumping, your nipple should fit nicely in the flange, with no areola (a sign the flange is too large) and your nipple should freely move within (if it doesn’t, this is a sign the flange is too small). Medela uses this great visual aid for determining correct fit. You can also always ask a lactation consultant to show you how to use your pump correctly.
- Thrush. Your baby can pass this yeast infection on to you, which can cause nipple damage. If you happen to get infected first, you can also pass it on to your baby. Signs you might see if you have thrush include itchy, red, shiny, painful nipples, as well as shooting pains in the breast before and after feedings.
- Baby might be tongue-tied. It might be possible that the tissue that connects baby’s tongue to the floor of his mouth is too short or it extends too far to the front of the tongue, also known as a tongue-tie. If your baby is tongue-tied, he can undergo a frenotomy, a very minor surgery, and his sucking should improve immediately.
- Dry skin or eczema. Eczema might be itchy or painful and looks red and scaly. Seek help from a dermatologist in this case.
Is pain with breastfeeding normal?
When I first became a mom, every time someone said “breastfeeding shouldn’t be painful”, I felt like shoving them a mile away (as if that would help somehow).
In my mind, it was like “a tiny human is suddenly sucking on my nipples for half the day. This is new. Of course my nipples are going to hurt!” There is some classic pain associated with breastfeeding which is not usually problematic:
- Latch on pain which lasts no more than 30 seconds.
- Pain is the worst around the 3rd day postpartum but ceases altogether after no more than 2 weeks.
- No nipple damage, aka no cracking, blisters, or bleeding!
- Nipple looks the same when you’re done nursing; not flattened, creased, or pinched.
Just about every lactation consultant I’ve come across agrees that nipple pain beyond this is not normal and indicates there is a problem that needs fixing. At least you can breathe that sigh of relief that you’re not crazy!
How can you treat your cracked nipples?
Like you would treat anything wrong with your body, first call your lactation consultant, or you can find one close to you on USLCA’s site. While you’re waiting for professional assistance, there are certain things you can do to make nursing a little more comfortable:
- Nurse at least every 2 hours. Feeding frequently helps make sure that baby doesn’t become too hungry so that he doesn’t nurse too aggressively at your breast.
- Take a mild pain reliever such as Tylenol or Ibuprofen 30 minutes or so before nursing. Both medications are compatible with breastfeeding and can relieve some discomfort during nursing sessions. Note: be sure to follow the instructions on the pill bottles regarding dosages, as there is a limit of how much Acetaminophen and Ibuprofen your body can handle per day!
- Hand express or pump until you letdown. This will also help your baby not to feed too aggressively.
- Open both sides of your bra during nursing sessions.
- Nurse on the least sore side first (if there is one) because your baby will nurse more ravenously on whichever breast he’s on first.
- You can apply warm wet tea bags to your nipples for a short time as this may be soothing.
- Warm, moist compresses (i.e. a warm, wet washcloth) will also feel soothing to your sore nipples.
- You can also pat your nipples dry and then express some breastmilk and rub into your nipples. Breastmilk contains vitamin E which is great for healing. Note: do NOT apply Vitamin E oil from a capsule onto your nipple; this can be toxic to the baby.
- Apply a 100% USP modified lanolin preparation (i.e. Lansinoh, Medela) to your nipples and areola. Lanolin is safe for baby to ingest so you don’t need to wash it off before each feeding. There does seem to be some disagreement about whether maintaining the internal moisture of the skin (which lanolin does) quickens the healing process or not. Some consultants suggest letting the nipple dry completely in between feedings, and others advise to leave the nipple moist so the damaged areas don’t scab over. This would cause the wounds to re-open each time the baby feeds which may prolong the healing process.
- Use nursing pads made with 100% cotton and avoid pads with plastic linings, as this prevents air flow to the nipples. If the pad gets stuck to your nipple you can moisten it with water before removing it.
- If it is just too painful for you to nurse while healing, you can feed your baby with a medicine dropper, spoon, flexible medicine cup, or a nursing supplement until you have healed enough to continue nursing. Lactation consultants suggest avoiding giving your baby a bottle if the source of your cracking and pain is from poor latch-on. This may cause even poorer latch-on when you go back to nursing because he will try to latch on to your breast the same way he was the bottle.
- The below video by a LC out of Georgia gives a great visual of how to care for your cracked nipples and makes some of the best suggestions (in my opinion) to make you feel more comfortable in between nursing sessions. Of course, nothing will beat one-to-one help from your own lactation consultant!
Once your poor nipples heal, I can assure you those stories you’ve seen and heard about the beauty of breastfeeding will prove to be true for you and your babe!
Nurse on mama, and know of your global wide support!