A mother’s guide to cracked nipples

A small person hanging off your breast was always going to be more awkward in practice than in theory, but many mums are also surprised to discover the complications that can sometimes accompany the act of breastfeeding. While many women experience cracked or grazed nipples and accept the discomfort and pain as part of their journey, they aren’t actually a normal part of breastfeeding. Early intervention and prompt treatment can reduce pain, prevent more damage to the area, and help you start to heal.

Help, my nipple is cracked!

Many of us will never fully grasp the mysteries of the humble nipple – luckily, our International Board Certified Lactation Consultants and Women’s Health Physiotherapists can provide the answers.

5 common causes for cracked and grazed nipples while breastfeeding

1) Latch-Lustre

The most common cause of nipple discomfort is an improper latch. Incorrect positioning of yourself or your baby can contribute to this and may cause the nipple to be squashed as they feed. On top of the pain, squashing can lead to damage and restriction of milk flow, and (you’d think babies would realise this) that benefits no one.

While it may take some time and adjustment to find a position comfortable for you (and bub), remember that there is no ‘right’ way to breastfeed; it may look and feel different to how you imagined, but then, so may parenthood.

If practice ≠ perfect, an appointment with one of our Lactation Consultants can help you to position your baby to get a better latch.

2) Thrush – Six letters and a whole lotta pain

Not a word any woman likes to hear, but sore, shiny, cracked, or itchy nipples may be a result of thrush. Breast thrush pain can vary from stabbing/shooting pains to a deep ache or burning sensation through the breast during or after feeding.

3) If not Thrush, then what?

Similar symptoms may be a result of a bacterial infection or (at the risk of sounding alarmist) multiple bugs. But before going down one of Dr. Google’s rabbit holes, it’s best to book in with an actual GP so that an appropriate diagnosis and treatment can be sought. A GP specialising in mother health is your best bet.

 4) Could it be a Tongue Tie?

When a baby has a tongue tie, the tongue is unable to draw the breast into the baby’s soft palate, causing the nipple to rub on the hard palate. The baby may also be chomping or biting rather than sucking in an attempt to access the milk. The Baby Steps Tongue Tie Clinic can conduct an assessment involving both the GP and lactation consultant to determine treatment.

5) Dealing with Dermatitis or Eczema

Good news – it’s just a skin condition. Bad news – your nipples still hurt like a….

Thankfully, a GP or lactation consultant will be able to determine the cause and rule out the others.

Breastfeeding tips for managing cracked or grazed nipples

There are some things you can do to minimise nipple pain and help prevent cracking/grazing in each stage of a breastfeed.

Pre-feeding tips in the management of cracked or grazed nipples

• Paracetamol and ibuprofen are your friends – try taking about 30 minutes before feeding.
• Ice Ice Baby – some slight numbing pre-feed could make all the difference.
• Express Yourself – applying a warm washcloth to the breast and gently massaging or expressing some milk can help to soften the areola and lubricate the nipple.
• Pump away – pumping for a minute or two before nursing will make the nipple easier for your baby to latch, especially if engorgement is causing a shallow latch.

How to manage cracked or grazed nipples while feeding

• It may seem counterintuitive, but an off-centre latch, with more of the areola below the nipple in your baby’s mouth, is the best position and most effective in healing your nipples.
• Try the least sore breast first – this is a strategy that transfers to all sports, games and wars.
• More frequent nursing (at least every 2 hours) will lessen the ravenous nature of a hungry baby. By following your little one’s feeding cues, you may be able to avoid the crying and chomping and instead, find some sense of symbiosis.
• If unsure about the desired duration of a feed, a lactation consultant can help to determine if your baby is feeding effectively and often enough to transfer milk.

What to do about cracked or grazed nipples after feeding

• If your baby hasn’t detached themselves, try inserting your pinky into the corner of their mouth to break the suction, allowing you to pull them off your breast more gently (the cute popping sound will also distract you).
• Clean your nipples gently with warm water and make sure to pat your nipple dry or air dry.
• For mildly cracked or tender nipples (not bleeding) try rubbing a little expressed milk over your nipple and allow to dry. The anti-microbial properties can ease irritation (aren’t we a nifty species?).
• Try a nipple cream, balm or antibacterial ointment. You may need something ‘harder’ (i.e. prescribed) if your nipples are cracked, but your healthcare provider will advise.
• To prevent further irritation from your bra, try wearing a plastic breast shell inside your bra to create space between your breast and bra. Make sure to wash between wears and don’t wear them against engorged breasts as this can impede milk flow and lead to plugged ducts.

“Don’t give up on us, baby”

If you feel like you’ve tried it all and yet haven’t managed to come away unscathed, YOU STILL HAVE OPTIONS.

Our lactation consultants are always at your disposal to offer other solutions, and a physiotherapist may be able to help with laser or ultrasound therapy for healing and blocked ducts.

Because (unless you’re Chandler Bing) you only have two nipples – let’s make sure they last.