Did you know that one of the most common reasons given why new mothers discontinue breastfeeding during the first few weeks is due to sore nipples? Breastfeeding is not supposed to hurt but the fact is, most mothers will experience some degree of soreness during the early stages of breastfeeding.

Nipple soreness usually begins during the first few days of breastfeeding and will peak around the 4th or 5th day and then will begin to lessen.

Around day 7-10, breastfeeding should be completely pain-free. If nipples are cracked or bleeding, pain persists beyond the first few weeks or if you are experiencing a burning sensation, to identify and correct the problem, please seek assistance from an International Board Certified Lactation Consultant or your primary care provider, who is knowledgeable in breastfeeding.

The most common reason for nipple soreness is due to an improper latch and positioning. Even though breastfeeding is supposed to be natural skill, it is also learned a skill. It can take awhile for not only the baby but for the mother as well to master the techniques of breastfeeding.

As an International Board Certified Lactation Consultant (IBCLC), I suggest if you’re having any issues with latching and positioning, watching the following videos:

Another common cause of soreness is due to engorgement. This is when the breasts become so full of milk, and other fluids that they become hard and tight and the nipple becomes flattened. That predicament makes it difficult for the baby to latch on. Engorgement typically begins around the 3rd to the 5th day post-partum and subsides within 12-48 hours if properly treated.

The best way to prevent and manage engorgement is by breastfeeding frequently. There is no advantage to limiting feedings, as babies need to breastfeed often, which will help to increase/maintain milk production and also satisfy the need babies have to suck.

The American Academy of Pediatrics recommends that healthy, full-term newborns should breastfeed 8-12 times in each 24-hour period. This equates to feeding every 2-3 hours. If your baby is latched on correctly, it should not hurt or cause damages — no matter how often or for how long the baby breastfeeds. If your breasts do become engorged, try a gentle breast massage, apply heat and then hand express out a small amount of milk (just enough so that you are soft and comfortable) before attempting to breastfeed.

This will help to soften the areola, which will help allow the baby to latch on. You can watch a video on how to hand express milk at: http://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html

For a gentle breast massage to help with engorgement, use the palm of your hand and starting from the top of your chest (just below your collar bone), gently stroke the breast downward in a circular motion, toward the nipple. This may be more effective when done while you are in the shower or while leaning over a basin of warm water and splashing water over your breasts.

To try hand expression of milk, place your fingers on the opposite sides of your areola. Press back toward your chest wall and compress your fingers toward each other, drawing slightly toward the nipple but not sliding the skin. Release pressure and relax your hand. Repeat several times. Shift your hand to a different position to move milk from other ducts.

Breastfeeding education during pregnancy will help to enhance your breastfeeding experience. If your little one has already been born, determining the cause of your sore nipples is the first step toward healing your nipples and resuming a pain-free breastfeeding experience. LVMC lactation consultants are here to help when you have issues. Breastfeeding mothers may join our Breastfeeding Support Group, which is held from 10 am to 11 am every Friday in the Lompoc Valley Medical Center Board Room. You can also join our invitation-only Breastfeeding Support Group Facebook page.

If your needs are more immediate, please contact us Outpatient Lactation Service at (805) 737-3395.

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About the Author

Author: Natalie Mendenhall , Lactation Program Coordinator

Natalie Mendenhall is a Certified Lactation Consultant and co-coordinator of the Lompoc Valley Medical Center Breastfeeding Program. An Arroyo Grande native, she received a Bachelor of Science degree in Nursing from Touro University in Nevada in 2013. She received her California RN license in 2014. Natalie graduated as a Certified Lactation Consultant from the University of California at San Diego and became an International Board Certified Lactation Consultant in 2018. She completed internships in IBCLC at Twin Cities Hospital and Women, Infants, and Children (WIC) Food and Nutrition Service in Grover Beach.

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