Sore Nipples and Breasts in Breastfeeding Mothers
It is common for mothers to experience some form of soreness in the breasts or nipples, especially when the child first latches on to the breast during the first few weeks of breastfeeding. However, if the discomfort intensifies and becomes painful, if there are visible sores on your nipple or areola (darker skin around the nipple), or if you are thinking of stopping breastfeeding because of the pain, seek medical advice.
Causes and triggers
There are many possible causes for nipple and breast pain. Improper latching to the nipple by the baby is the most common cause. Other sources of pain during breastfeeding include:
- Cracked or fissured nipple or areola
- Fungal (yeast) or bacterial infections
- Eczema on the nipple or areola
- Nipple vasospasm (reduced blood flow in the nipple)
- Use of an irritating or allergy-causing product on the nipple or areola (soap, cream)
- Engorgement, mastitis and abscess
Mothers with chronic skin conditions (e.g., eczema) and those who suffer from Raynaud's disease (small blood vessel spasms) or diabetes are at a higher risk. Any condition in the child that hinders proper latching can also cause pain. Among some of the most common conditions in children are a short lingual or labial frenulum, a cleft lip or palate, a lack of muscle tone or being preterm.
Symptoms
The severity of symptoms and pain varies depending on the cause.
Poor latch: severe pain when the baby begins to nurse but gradually diminishes during the feeding. Can lead to sores including chapping, fissures and cracks on the nipple and areola if latching is not corrected.
Fungal infection: pain is present for the entire feeding and even afterwards in some cases. The pain is described as a stabbing or burning sensation. Nipples and areola may appear cracked, redder than normal or shiny. Thrush in the child's mouth or a fungal infection on the baby's buttocks may also be present.
Bacterial infection: intense pain accompanied by red irritation with or without pus.
Eczema: pain described as burning or stabbing. The nipples and areola appear dry and red. The number of sores increases when the area frequently goes from dry to moist. There are often lesions elsewhere on the body. More common in those with asthma or allergies.
Nipple vasospasm: pain described as a burning sensation that only starts once the feeding is completed. The nipple turns pale in response to cold temperature, breastfeeding or following an injury. It may take several minutes for the nipple to regain its normal colour.
Treatment
Before initiating any kind of treatment, a comprehensive evaluation of the baby's latch, breastfeeding position, as well as the physical condition of both mother and the baby should be carried out by a qualified lactation consultant. Treatment may involve adjusting the latch, applying topical or oral medication, among others.
Adequate follow-up is the key to successful treatment and will allow the mother to continue breastfeeding under the best possible conditions. It is good to know that it is safe to breastfeed in case of mastitis or pain.
Prevention
- The best prevention is to make sure that the baby is properly latched and positioned at the breast from the very first day.
- Changing breastfeeding positions can help by shifting the pressure area on the nipple.
- Applying warmth or cold can provide relief depending on the type of pain.
If you experience pain in spite of taking precautions, consult as promptly as possible to prevent worsening the situation, and to prevent the premature discontinuation of breastfeeding. If you have any questions, speak to a health care professional.