Nipple Problems

Even though soreness and bottle preference may get in the way, most women successfully breastfeed. Here’s how to address common problems.

Inverted or Flat Nipples

Babies nurse areolas, not nipples! So don’t worry if initial feedings feel a bit more difficult because of flat or inverted nipples.

Here’s what you can do:

• After you’ve delivered the baby, pump or hand express to help make the nipple more erect.
• Don’t roll, twist or pull on your nipple.
• Short-term use of nipple shields, which hold the nipple in an extended position, may be helpful (especially for premature babies).
• Always use shields under the direction of a doctor or lactation consultant. As your baby gains strength, you’ll no longer need a nipple shield.
• Consult a lactation consultant for additional help.

Sore Nipples

The main cause of nipple soreness is nipple trauma due to baby’s incorrect positioning on the breast. However, even with proper positioning, some women may experience short-term latch-on soreness.

For less pain and a better latch:

• Make sure your baby’s mouth is wide open (like a yawn).
• Start with your nipple opposite your baby’s nose.
• If you feel pain that lasts throughout a feeding, break the suction, remove your baby, reposition and try again.
• Ensure a proper release by inserting a finger between your baby’s jaws to break the suction before removing your baby from your breast.
• Make sure your baby’s lips are not turned under and that your baby isn’t chewing on your nipple or sucking his tongue. Pull down firmly on your baby’s chin to unhinge the jaw and widen the mouth and allow the lower lip to roll outward. Use your index finger cupped under your breast or your thumb on your opposite hand.
• If your baby is sucking her tongue, you may hear a smacking sound and see your baby’s cheeks caving in. Take your baby off the breast, reposition and try again.
• Try different positions until you and your baby find a comfortable routine.
• Express some breast milk onto your nipples after a feeding and then allow your nipples to air dry completely.
• Apply a warm, wet washcloth to your nipples to sooth irritation.
• Consider applying a small amount of pure lanolin (such as Purelan 100 Lanolin Cream or Lansinoh Organic Nipple Balm) to your nipples if they have sores. You don’t need to wash the lanolin off before breastfeeding.
• Consult a lactation consultant for additional help.

To keep the nipple area free from irritation:

• Avoid using drying breast creams that contain alcohol. Breast glands secrete a natural oil for lubrication and protection.
• Try more frequent and shorter nursing periods, instead of longer feedings.
• If you think you need a nipple shield, talk with a lactation consultant or your healthcare provider.
• If using nursing pads, change them often. Consider using 100 percent cotton washable bra pads. Avoid pads with plastic or moisture-resistant liners.
• Wear clean, supportive nursing bras. Avoid tight or poorly fitted nursing bras.
• Discontinue use of any breast pump that causes discomfort and contact a lactation consultant.