January 20, 2020
Sore nipples are extremely common during the first few weeks postpartum. This is due to a variety of factors associated with lack of deep latching. Infant problems such as torticollis, tight jaw muscles, sleepy behavior at the breast, tongue-tie, and maternal problems such as eczema, very large nipples, inverted, or very flat nipples also contribute to sore nipples during the first few weeks1.
The most important early interventions include optimizing the infant’s position and latch in order to promote a deep atraumatic latch. The dyad may need to be seen by a lactation specialist for this. If skin is intact, some mothers find an emollient soothing, such as purified lanolin, when applied after nursing. If the mother has open nipple wounds, the principles of moist wound healing and preventing the wound from sticking to a surface will help to promote healing. (See the section on “Nipple Wounds” in Acute Nipple/Breast Pain) As long as the latch is no longer traumatic, her nipples will usually heal in a few days despite continued breastfeeding.
Depending on the degree of pain, mothers who need a break from nursing should be instructed to pump instead of breastfeeding. Pumping can also be traumatic, so it is important that she receive guidance on proper pump selection, shield size, and pump usage. See Pump Technology.
- Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #26: Persistent Pain with Breastfeeding Breastfeeding Med1(2) 2016