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Sore nipples and breasts! Is it normal?

Sore nipples and breasts! Is it normal?

Nipple and breast pain

Some discomfort in the first week of breastfeeding is common but if pain persists it is important to seek help as early as possible.

Sore nipples

  • In the first few weeks the most common cause of sore nipples is due to positioning and attachment issues. Having an International Board Certified Lactation Consultant (IBCLC), or a health professional knowledgeable about breastfeeding, watch a breastfeed and suggest small changes can make all the difference.


  • Has your baby been checked for tongue-tie? Many hospitals routinely check before discharge, but not all. Less obvious (posterior) tongue ties may go unnoticed. Baby Steps Health Centre has a Tongue and Lip tie clinic twice a week, where breastfeeding is assessed and tongue ties can be affordably treated on the day.


  • If pain continues past the first week or suddenly appears after a period of pain-free breastfeeding consider nipple infection. Nipple swabs and milk samples can be taken to rule out bacterial or thrush infection.


  • Other reasons for sore nipples may be related to nipple vasospasm, pregnancy, teething, skin conditions (eg. dermatitis).

Breast pain

Sometimes a nipple infection can spread to the breast. Consider breast infection if you feel breast pain at any time (eg. Shooting, stabbing, burning, aching)– swabs and milk samples can be taken to rule out bacterial or thrush infection.

Milk blisters on the tip of the nipple can often cause breast pain. They can prevent milk from leaving the breast, leading to blocked ducts.

Check your breasts for any lumps or hard areas. Therapeutic ultrasound treatment for persistent blocked ducts is available through Baby Steps Health Centre, provided by Genesis Physiotherapy.

There are many treatment options available depending on the cause of breast and nipple pain. A Baby Steps IBCLC can advise you, together you can work out a plan to reach your breastfeeding goals.

Call to action:

  • Book “Tongue Tie assessment” appointment
  • Make an appointment to see one of our Baby Steps Lactation Consultants today.
  • See Babysteps Lactation Consultant for nipple swabs to rule out infection.


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  • Position and attachment
  • Oversupply and engorgement
  • Expressing
  • Pain while feeding
  • Cracked nipples
  • Mastitis
  • Low supply
  • Flat/inverted nipples

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Download our guide sheet about "Common Breastfeeding Concerns" and book an appointment with our Lactation Consultant today



Baby Steps Health Centre is a professional caring service for new families led by experienced GP Obstetricians, Child Health Nurses, and Lactation Consultants supported by Women’s Health Physiotherapists, Dietitians, Speech Pathologists, Psychologists and Paediatric Physiotherapists.

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    Breast fullness

    Breast fullness is a normal process and occurs around 3 days after birth or whenever the milk “comes in”. Your breasts can become larger, heavier and tender, this will generally only last a few days. However some mother’s breasts become very swollen and sore. Engorgement is caused by a buildup of blood, milk and lymphatic ­fluids.


    • Firm, tender and or painful breasts

    Engorgement is important to treat for several reasons:

    • It can be painful and extremely uncomfortable
    • It can lead to mastitis if not managed effectively
    • It can be physically difficult to attach your baby to the engorged breasts


    • Frequent, unrestricted feeding
    • Ensure good position and attachment – see LC for extra support
    • Cold compress after feeds
    • Reverse pressure softening – see LC for more details
    • Ibuprofen may help
    • Use warmth before a breastfeed to help milk fl­ow
    • Handle breasts as little as possible
    • Gentle ‘cat-like stroking’ towards the armpit may be helpful in a warm shower
    • Expressing can be effective in helping manage engorgement symptoms. However, each

    situation is unique, and should be discussed with your Lactation Consultant.

    Call to action:

    • Book appt with Lactation Consultant
    • Book Ultrasound (Genesis Physiotherapy)
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    Mastitis is inflammation/infection of the breast tissue that results in breast pain, swelling, warmth and redness. You also might experience a sudden onset of fever and flu like symptoms.

    Mastitis can begin as milk stasis or blocked ducts which occurs when milk is not e­fficiently drained from the breast/s. Cracked or damaged nipples can provide an entry point for infection



    • Flu like symptoms. Aches, chills +/- fever (usually sudden onset)
    • Red, hot and often painful area on the breast
    • Lumpy/hard area on the breast


    • Feed baby often to ensure frequent regular draining. Allow baby to determine length of feed or a pump may be useful.
    • Ensure good positioning and attachment to encourage good milk transfer
    • Rest and increased fluids
    • Warm and cold compress.
    • Warm: Before and throughout feed, to open the milk ducts and allow maximum drainage
    • Cold: After feeds to relieve pain and inflammation
    • Treat the pain: Ibuprofen is considered effective, as it is both a pain reliever and anti-inflammatory
    • If you have a fever or flu-like symptoms with a painful engorged area of your breasts, you may need antibiotics and must see your doctor or a Baby Steps GP urgently.

    Act promptly on symptoms. A small percentage of mothers may develop a breast abscess if mastitis is left untreated.

    REMEMBER: Continue to feed. Some mothers worry about passing on an infection to their babies when breastfeeding. Be assured that this is not the case. It is OK for your baby to drink the milk from the affected breast. Though some babies do notice a change in taste (saltier) and may become fussy at the breast.

    Call to action:

    • Book Ultrasound treatment by a Women’s Health Physiotherapist to help clear a blocked duct (Genesis Physiotherapy)
    • Laser treatment to damaged nipples to prevent infection (Genesis Physiotherapy).
    • Make an appointment to see one of our Baby Steps Lactation Consultants
    • Make an appt with our GP for antibiotic therapy
    • If mastitis is recurrent consider booking to see our Lactation Consultant to get nipple swab and breastmilk culture.
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