Sore and cracked nipples (nipple fissures)

Sore and damaged nipples are a common problem, especially at the beginning of breastfeeding. They can make breastfeeding difficult, cause discomfort, and sometimes lead to giving up breastfeeding. Fortunately, there are ways to prevent this problem, and to cure it quickly and successfully if it does occur.

The most common cause of painful nipples is improper breastfeeding technique - poor positioning of the baby on the breast. Other causes may include:

  • breast engorgement
  • infection
  • short lingual frenulum (frenulum of the tongue)
  • too frequent and long breastfeeding sessions (if you do not know how to calm the baby and you offer the breast as soon as he/she cries) or "sleeping" on the breast
  • individual sensitivity.

Signs and symptoms

  • Pain in the areola or nipple.
  • After breastfeeding, the nipple is lumpy, warm, red, chafed, bleeding.
  • The breast is sometimes swollen, enlarged, and there may be blood in the matter gagged by the baby.

Prevention

If you know the possible causes of breast fissures, you also know how you can prevent them. Breastfeeding should not hurt; when you pull the nipple out of the baby's mouth, it should not be flattened and deformed.

  • Check how the baby latches on the breast and correct the position if necessary
  • Wash your hands regularly
  • Thrush must be treated if it occurs
  • Avoid nursing pads as they are conducive to infection
  • After breastfeeding, wash your nipples with lukewarm water, dry them (by light tapping, without rough rubbing) and apply your breastmilk on the nipple tissue to help recovery, and then expose your breasts to air.

Treatment

  • Put warm compresses on your breasts before breastfeeding to stimulate milk flow; the pain is strongest at the beginning of breastfeeding, until the milk starts flowing.
  • Start each breastfeed with the breast that hurts less.
  • Avoid limiting the frequency of breastfeeds; do not reduce the number of breastfeeds.
  • If the damaged area bleeds severely, do not breastfeed on that breast for 1-2 days. During this time, empty it regularly by manual expression every 2-3 hours. Give the baby milk with a teaspoon.
  • Silicone nipple shields are not recommended for use except in rare cases and should be used for as little time as possible. If you use them, ensure they are clean before use.

All these measures should lead to improvement within a few days. If the discomfort does not go away, there is still redness and pain in the form of burning or stinging, you may have a nipple infection. It is most often caused by bacteria (Staphylococcus aureus) or fungi (candida), and can also be mixed. You need to see a doctor for treatment. The doctor will check if there is a problem with the baby: thrush (candidiasis) that needs to be treated or short lingual frenulum (frenulum of the tongue) that may need to be corrected.

Even if your nipples are too painful to breastfeed the baby, you still have to express milk. If you do not empty your breasts regularly, plugged milk ducts and mastitis can occur. Irregular emptying can also lead to reduced milk production.