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<h1>Breastfeeding - www.breastfeeding.org.nz</h1>

Nipples


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How do I prepare my nipples for breastfeeding?


Pregnancy and the accompanying hormonal changes prepare the nipples for breastfeeding – mothers don’t have to do anything aside from ‘read-up’ on breastfeeding and try to observe/talk to someone who is currently breastfeeding.

I have sore nipples, is this normal, what can I do to stop the pain?


Nipple tenderness is common whilst breastfeeding is being established (especially in the first 7-10 days post-delivery). However continuing pain during the breastfeed is not ‘normal’ and suggests that the position and/or latching of the baby is incorrect.

Tender and sore nipples are normal until the breasts become used to breastfeeding (within 7-10 days). Peak time for nipple tenderness is in the first week after the baby’s birth. The area in and around the nipple is full of nerve endings which is why many breastfeeding mothers feel so sore in the early days of breastfeeding establishment. The nerves stimulate the release of oxytocin and the ‘let-down’ of the breastmilk. Once the breastmilk starts to flow the tenderness should wear off.

Sore nipples that continue into the breastfeed are not normal and the main reason for the pain in the early days of breastfeeding establishment is the baby squashing the nipple which is most often a consequence of incorrect positioning and/or latching. Nipple soreness which extends into the second week of breastfeeding or gets worse instead of better is a sign that help is needed.

If the problem remains undiagnosed or the baby continues to squash and rub a nipple, this may lead to nipple cracks and damage which can in turn lead to not only unpleasant and painful breastfeeding but infection of the nipple and/or inside the breast.

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My nipples are cracked and bleeding, what can I do?


It is critical to seek advice from a Lead Maternity Carer (LMC) immediately and if there is an infection this will need to be treated, including how to heal the nipples whilst continuing to feed the baby.

There is no research to show any benefit of using creams or ointments for cracked nipples. If the nipples are so painful and tender that a mother is unable to face putting the baby on the breast it is best to seek immediate advice and practical assistance from the LMC immediately. A practical soluntion may involve resting the nipples (from breastfeeding) to assist with healing. This will mean that there will be a need to express breastmilk from the breasts to maintain lactation and to provide breastmilk for the baby.

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I have flat nipples, can I breastfeed?


If nipples are very flat or inverted the baby may be able to get on them without difficulty once they have become more expert at breastfeeding. Meanwhile this could be one of the very few indications to use a nipple shield which is a soft silicone device looking a little like a small Mexican hat, which goes over the nipple and areola to assist the baby to achieve a latch.

Nipple shields cannot be used before there is a good milk flow. There is mixed research about milk supply and use of nipple shields. Some mothers may experience a reduced milk supply over time if they continue to use a nipple shield. In these cases breastmilk expression may be necessary as well as the breastfeeds. Ask for advice about using nipple shields if continuing to use them on a long term basis.

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Page last reviewed: 31 July 2008


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