Sore or cracked nipples

It’s not uncommon to get off to bit of a rocky start in the first week or two of breastfeeding, since it’s a physical experience that asks brand new things both from your body and from Baby’s. One of the challenges that can come with breastfeeding is the pain that comes with dry, sore, or cracked nipples. 

Why do dry or cracked nipples happen? 

Most nipple pain and soreness happens when a baby is latched on or positioned improperly, which compresses the nipple in uncomfortable ways. It’s because of this that nipple soreness and cracks appear most often in newly-breastfeeding pairs, often in the first 3 to 7 days of breastfeeding, before the baby has had time to fully master breastfeeding. After the first few weeks, nipple pain is not a normal consequence of new breastfeeding. It is usually caused by a problem with positioning or latching during breastfeeding, though it can also be caused by other physical issues like a tongue- or lip-tie, short tongue, or small mouth. Flattened, wedged, or whitened nipples at the end of a feeding are other possible physical signs of an improper latch that’s causing, or could cause, pain.

Thrush or other infections of the breast can also cause pain and discomfort around nursing. Having dry or cracked nipples can also increase the risk of a breast infection like mastitis.

How can I treat dry or cracked nipples? 

If you’re concerned that an improper latch or other physical issue might be causing nipple pain or soreness, the first thing to do is work to fix the latch. Many doctors aren’t fully familiar with lactation problems, so a lactation consultant is often the best person to consult with so they can talk you and your baby through alternate holds, positions for feeding, or ways of latching on. In terms of more immediate relief, depending on the type of soreness you’re experiencing, there are a few different things you can try:

  • For dryness: Soap can dry nipples out further, but rinsing them once a day with warm, clean water can help, as can letting them dry on their own before getting dressed, either after nursing or after bathing. Letting breast milk dry on the nipples can also help soothe pain. A cotton, non-underwire bra provides breathable fabric and support without compression, and for extremely dry nipples, some healthcare providers recommend lanolin creams or other ointments to help soothe dry skin while also sealing in natural moisture. Some evidence suggests that lanolin and other creams may not help to heal the nipple, but there are many creams and ointments that are perfectly safe for both you and Baby to try during breastfeeding (although moms with wool allergies should avoid lanolin creams).
  • For soreness: Warm, moist compresses, like washcloths soaked in warm water, can soothe soreness, and supporting the breast from below during nursing can help to keep it from pulling out of the baby’s mouth during nursing, which can cause pain and soreness. Acetaminophen or ibuprofen are also safe to take for pain while the nipples heal.

  • For healing: When dry or cracked nipples are healing, it’s especially important to wash hands with hot water and soap before handling them, to prevent infections. Nipple shields won’t solve any underlying concerns about nursing, but under the care and recommendation of a lactation consultant, they can give the nipples a chance to heal without stopping nursing or drying out further. Under the nipple shields, antibiotic ointments like bacitracin or mupirocin can be applied to cracked nipples to prevent breast infections.

Dry or cracked nipples can lead to infection, and can lead to a shorter breastfeeding period than might originally have been planned. If problems with nipple pain, soreness, or dryness continue, don’t hesitate to talk to your healthcare provider about how you and your little one can streamline the feeding process until it’s comfortable for you both.

  • Jahaan Marten. “Nipple Pain: Causes, Treatments, and Remedies.” Leaven. 36(1): 10-11. Web. February-March 2000.
  • Mayo Clinic Staff. “Breast-feeding tips: What new moms need to know.” Mayo Clinic. Mayo Clinic, November 23 2016. Web.
  • “Breast-feeding questions.” HealthyChildren. American Academy of Pediatrics. Web.
  • “Sore or cracked nipples when breastfeeding.” NHS Choices. Gov.UK, March 20 2014. Web.
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