Breastfeeding: How to heal sore nipples

New mother Neeta is struggling to breastfeed her six-month-old baby boy. The prime reason is that she has a cracked nipple due to feeding. To make matters worse, she has also developed fever and soreness of the breast is refusing to heal.

Neeta is not alone. New mothers often come across this problem of painful cracked nipples during breastfeeding. One of the most common reasons for young mothers to stop breastfeeding their infants is sore or cracked nipples.

Why does breastfeeding result in cracked nipples?

There could be several reasons behind cracked nipples. The main causes are:

• Inexperienced first-time mothers take some time to figure out the right techniques of breastfeeding. If the position of the mother and the baby during feeding is not correct, it could lead to cracks in the nipple.
  
• If the baby latches to the mother’s breast wrongly, it causes constant friction between baby’s palate and the mother’s nipple skin. This leads to cracking of the nipple.
  
• In case of engorged breasts, where breasts become hard, swollen and painful due to an accumulation of too much of breast milk, the nipples become flat and cannot enter the baby’s mouth properly. The baby tries to bite it to be able to suck. This leads to trauma and cracking.
  
• Bottle and breastfeeds require different sucking pressures and techniques. When the bottle-feeds baby sucks on the breast with the same pressure, it leads to cracking.
  
• Sometimes, fungal infections in the baby’s mouth or the mother's skin can also lead to cracking. In some cases, yeast infection is the cause of cracking of the sensitive skin around the nipple.
  
• If the mother suffers from other skin ailments like eczema, allergy and dry skin, it can cause cracked nipple too.

What should you do to prevent it?

Generally, all maternity hospitals and doctors conduct awareness for new mothers on the techniques of correct breastfeeding. It is a must-attend for new mothers.

• When you are breastfeeding, make sure at least one inch of the areola (the blackish skin around the nipple) must be inside the baby’s mouth.
  
• Do not use harsh soaps on the nipples to clean, use gentle washes.
  
• After feeding, rub some amount of the breast milk on the nipples for lubrication and soothing. Thereafter, keep the nipples dry in between feeds.
  
• Use only cotton feeding innerwear. Ensure you have a well-fitting bra. Adequate support protects the breasts which become heavy because of lactation. If you are using breast pads, change them frequently. Maintaining hygiene helps to avoid painful nipples when you are breastfeeding.
  
• Ensure that you are exclusively breastfeeding your baby for the first four to five months of the child.
  
• Feed the baby at regular intervals. A hungry baby might grab the nipple, causing more pain.
  
• In case if the mother develops fever due to the fever, visit your dermatologist and get the skin treated immediately. If you see any fungal infection in your baby’s mouth, consult a doctor before feeding.
  

If the pain is more, should you stop feeding my baby?

The cracked nipple can be painful. However, you should not stop feeding the baby as the lubricants secreted by the glands on the nipple skin and, the breast milk, have healing properties.

If it is very painful, you can use a nipple shield to protect the skin of the nipples while the baby sucks on the breast.

In some cases, it becomes too painful for the mother to continue feeding, in such cases, one can express the milk and feed the same milk to the baby with a bottle, till the nipple heals. If the skin gets infected and there is tenderness in the breast and the mother develops fever, she must take a course of antibiotics and resume feeding as soon as she can. Abstaining from feeding for too long will lead to breast engorgement which will add to the discomfort

Can painkillers be used to treat the condition?

Anti-inflammatory drugs will be prescribed to you by your doctor depending on the severity of the cracking and pain. If you feel that the pain is not tolerable, and you need painkillers. However, do it in consultation with your doctor only and try to limit the number of days you are taking the medication as traces of these medications may travel to the baby in the breast milk.

Are there any other infections which can result in sore nipples?

Cracked nipples can also be due to:

• Dry skin or eczema: Detergents on clothes, irritants from perfumes, soaps, creams and lotions, dry air due to the usage of air conditioners, coolers and heaters can cause eczema. This can lead to soreness of nipples.
  
• Bacterial infection of the skin
  
• Fungal/yeast infection of the skin
  
• Skin disorders like psoriasis and atopic dermatitis
  
• Skin/breast cancers.
  

How to treat cracked and bleeding nipples at home?

• Use an ice pack before you feed the baby. This numbs the nipple as you latch the baby on and is one of the easiest remedies for cracked nipples.
  
• Use a small amount of breast milk to rub gently on the nipple immediately after feeding.
  
• Use 100 per cent lanolin ointment on the nipple in between feed and wipe off gently when feeding.
  
• If you are using nipple shields, ensure that you sterilise them appropriately to avoid infections.
  
• If you are expressing the milk and feeding the baby, ensure that the suction of your breast pump is not too strong.
  
• Massaging with warm oil to moisturise the affected area helps to soothe the breast. Oils like olive, sweet almond and coconut are effective in moisturising the area and boosting the healing process.
  

The author is a consultant Dermatologist, Cosmetic Dermatologist and Dermato-Surgeon. 

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