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My nipples are sore, cracked and bleeding! What can I do to ease the pain and how long will this continue for?

Oohh….sore, cracked nipples! They hurt. Poor positioning and latch-on is the most common cause of nipple soreness in the early weeks of nursing. Sometimes only a minor change of positioning and latch-on is all that is needed. While you are working on the latch-on, here are some measures you can take to help heal your nipples:

  • Nurse frequently - at least every 2 hours. This will ensure that your baby does not become too hungry between feedings causing him to nurse ravenously and aggressively at your breast.
  • Pump for a few minutes before the feeding. This will initiate a letdown and elongate the nipple for the baby so that he does not nurse so aggressively.
  • After feeding, pat dry your nipples and express some breast milk to rub into them. Breast milk has Vitamin E in it which is very healing to the skin. NOTE: Do not use Vitamin E oil from capsules etc as this can be toxic to your baby!
  • You may want to apply a 100% USP modified lanolin such as Lansinoh or Purelan preparation to your nipples after nursing. Apply enough to thoroughly coat the entire nipple/areola area. Breastfeeding specific lanolin preparations do not need to be washed off prior to nursing as it is safe for baby to ingest. Recent studies seem to indicate that using 100% lanolin may quicken the healing process by maintaining the internal moisture of the skin. Avoid using general body creams and lotions as these may actually impede healing by preventing air circulation and drying out the skin. Some of these preparations may also be toxic to your baby and will need to washed off prior to nursing. Over-washing of the nipple area results in a loss of the natural lubricants that protect it and provide it with antibacterial properties.
  • Try Hydrogel pads or Discs. I have found these to be helpful in healing sore, cracked nipples. These can be used in conjunction with a lanolin preparation.
  • Change your nursing pads immediately once they become even slightly damp. Moisture against your nipples can slow down healing. If your pad sticks to your nipple moisten it with water before attempting to remove it. Also avoid nursing pads with plastic linings. They prevent the flow of air which is essential to healthy nipples. Stick with 100% cotton nursing pads.
  • Warm, moist compressesoften bring relief to nipples both before and after nursing.
  • If you find it impossible to nurse your baby due to nipple soreness, you may opt to feed him with an alternative feeding device such as a feeding cup, while your nipples heal. If bottles must be used so with advanced teats that closely mimick the mothers nipples. Contact a lactation consultant for assistance in using a feeding cup. If only one nipple is very sore, you may decide to feed your baby from the well side only while pumping the other side. The baby can get all that he needs from one side as long as you allow him to nurse frequently. You will want to pump the other side as often as your baby nurses for 10-15 minutes each time. If taking the baby off both breasts and pumping instead for a few days is necessary, it's preferable to use a high quality double electric breastpump which will maintain your supply more efficiently till your baby is back to nursing.

Sore nipples shouldn’t last more than a week or so, so hang in there as it does get better! If pain persists or worsens, you should see your health care professional as soon as possible.