Sore and tender nipples

It’s difficult – if not impossible – to prepare for how painful breastfeeding can actually be in the beginning, because when a hungry little baby sucks, it can feel like being pricked by a thousand needles – or worse! Nipples are often very sore and sometimes get small blisters and sores, which of course doesn’t help. How long nipple soreness lasts can vary from a few days to a few weeks, but it is usually most painful in the first few days when the baby is sucking extra hard to start the milk supply.

In the midst of the stabbing pain, it’s important to remember that this is temporary and that breastfeeding shouldn’t hurt – in fact, most of the time it’s a wonderfully enjoyable time and a relief to empty your breasts. If the pain does not go away, it is often a sign that the baby’s suction technique is not quite right. This is something you should try to address right away to avoid long-term problems. Sometimes breastfeeding can also come with other discomforts, such as engorgement which can be painful and cause a fever, or thrush which can be transmitted from the baby if the baby has oral thrush. Another less than welcome surprise is if the little nipper bites your breast…

Tips for sore nipples

While waiting for your nipples to stop being sore, there are some tips to help ease the pain.

• Put something warm on your breasts before you start breastfeeding, such as a heat pad or a warm wheat pillow. The heat makes the breast milk flow so that the baby does not have to suck so hard.
• Try stroking your breasts with your hand to stimulate the let-down reflex.
• Express some milk so that the milk starts to flow before the baby latches on to the breast, this can help the baby get a better grip.
• If you have sore nipples, it can help to get the milk flowing before the baby latches on, as otherwise the small sores can burst open when the baby sucks hard.
• Allow your baby to feed often – it is easier for your baby to get a good latch on the nipple if they are not ravenously hungry and frustrated.
• Try to let your baby finish feeding on the breast that you started with before switching. If you have to interrupt or pause a breastfeeding session because of an urgent need to pee or something, help the baby to let go by gently inserting your own little finger into the baby’s mouth. Never just pull the baby off the breast – it’s not comfortable for either of you.
• Rub your nipples with breast milk after each feeding and let them air dry in between. Don’t use soap or lotions. If you need an emollient ointment, you can find one in the pharmacy; ask for one that is specially designed for nipples when breastfeeding.
• Wear a loose and comfortable top with a supportive and soft nursing bra underneath.
• Make sure your breasts are kept warm and dry, for example by making sure you change nursing pads when they feel damp.

If your breast becomes red, tender or warm, you may be experiencing engorgement. Sometimes the symptoms also include a fever or chills.

Breastfeeding and thrush

If you get a thrush infection in your breast, it may be itchy and painful. Sometimes the areola becomes swollen and the skin begins to flake. This is often because the baby has or has had thrush in their mouth, which then spreads to the breast when they feed. If you notice that your baby has oral thrush, it is a good idea to rinse your breasts before and after breastfeeding. If the thrush does take hold, remember to wash your bra every day and change your nursing pads. Sometimes you may need to treat both the baby and the mother to make them both thrush-free, but you shouldn’t do this on your own; you need to have the thrush diagnosed by a doctor first.

If your baby bites your breast

Babies can sometimes indulge in the extremely unpleasant habit of biting your breast. If it comes at the same time as a tooth emerging, it is of course particularly painful for the person being bitten. For babies with emerging teeth, biting can be a way to get relief. Sometimes the biting can also occur if you have a curious baby who won’t take their eyes off their surroundings and keeps turning their head – with the nipple in their mouth. Or maybe this is just the baby’s way of playing and seeing what the reaction will be… Whatever the reason, it’s not very nice for the person being bitten – so try this if your baby bites while breastfeeding:

• Keep a finger on the baby’s chin, and when you feel the bite starting, gently resist or press down so that the baby has no force to bite.
• If the baby already has a firm grip, it can be easier to get the baby to let go by placing your little finger in the corner of their mouth. You can then resume breastfeeding if your baby seems hungry. If the biting happens towards the end of the breastfeeding period, the little nipper may actually be full and just want to play.
• If the biting is due to the baby’s curiosity and desire to look all around, try breastfeeding in a quiet room or area where there isn’t much going on to distract from breastfeeding.
• If possible, try to keep a calm face and not to push the baby away – even if you want to scream with pain – instead say calmly and firmly that biting is not allowed. Otherwise your baby may perceive the reaction as playing and want to do it again and again, or your baby may become scared and upset.

Please note that all information above is based on Swedish recommendations.