Care Plan: Sore Nipples

Many books and well-meaning breastfeeding teachers say you should have no pain whatsoever if your baby is latched properly. This has likely caused much alarm among new mothers who wince when their baby latches.

Yes, a latch should be pain free when done correctly and your baby has the hang of it, but many times, even with perfect latches, there's some pain when you start breastfeeding. Your nipple and areola are sensitive areas that have never been subjected to such long and constant stimulation. Over time and as your baby learns to latch better, the pain should go away.

While sore, cracked or bleeding nipples are common in the early days, if you feel your latches are good but your breasts are becoming more painful, there's a plan to help you through this tough time.

Care Plan for Sore Nipples

• Don't put your baby on your breast for two feedings in a row. Instead, feed him with a bottle of expressed breast milk or formula.
• After bottle feeding, make sure you double pump both breasts simultaneously for 15 minutes. It's best to use the pump at the maximum level, but if that's painful try a lower setting. You might still experience some pain while pumping, but it shouldn't be nearly so bad as nursing. Give whatever milk you pump to your baby at the next feeding. If you didn't produce enough with pumping, you might need to give him some formula too.
• Soak your nipples in salt water. Mix 1 cup of warm water with ½ teaspoon of salt and stir to dissolve. Place the solution in two small glasses (shot glasses work well) and soak your nipples for several minutes as many times a day as you want. The saltwater soaks will soothe your breasts and speed healing.
• If you have scabbing on your nipples, dab them dry after the saltwater soaks and apply a thin layer of lanolin.

The most important part of this plan, besides healing your sore nipples, is to make sure you're pumping at every bottle feeding. This ensures your milk supply stays up, and the expressed milk can be used for the next feeding.

Your nipples should feel better after you've followed this plan. But if they're extremely cracked, you might need to keep your baby off your breast for 12 to 24 hours. If you do start breastfeeding again, you might need to take every other feeding off to continue the healing. Trust your judgement, and remember that you don't have to suffer through extreme pain.

Tips for success

• Sore, cracked or bleeding nipples are common in the early days of breastfeeding. The pain usually goes away on its own after you and your baby improve your latching skills.
• Make sure you pump every time you replace the breast with a bottle.
• Don't worry about nipple confusion if you need to give a bottle while your breasts are healing. As long as you continue to pump, your baby should be able to move back and forth easily from breast to bottle.

This information is courtesy of Bravado Designs, the brand synonymous with women's breastfeeding success for 18 years.

Source: Heather Kelly is an International Board Certified Lactation Consultant (IBCLC) who also sits on the Bravado Breastfeeding Information Council Heather has been practicing in New York City since 2001.