Nipple cracks during breastfeeding: causes, treatment and prevention

Breastfeeding should not hurt. Yet many moms experience sore or even damaged nipples in the first few weeks. Nipple fissures – small cracks or sores in the nipple – can make feeding very painful and sometimes even discouraging.

Fortunately, you can usually treat and prevent nipple fissures well. In this Milk Bar guide, we explain what to look out for and what you can do.

When are they nipple fissures?

In the first few days after birth, mild tenderness is normal. Your nipples need to get used to your baby’s sucking power.

After about two weeks, breastfeeding should no longer hurt.

There may be nipple fissures if:

• The pain lasts throughout the entire feed or gets worse while nursing

• You see cracks, scabs, or bleeding sores

• You dread every feed because of the pain

Don’t keep walking around with this. Pain during breastfeeding is a sign that something is not going optimally – and there is something you can do about it.

What causes nipple fissures?

The most common causes are:

1. Improper latch

If your baby does not latch deeply enough, too much pressure is put on the nipple instead of the areola.

2. Nibbling or poor sucking behavior

For example, when your baby only sucks on the nipple.

3. Thrush (fungal infection)

Thrush can cause sore, burning nipples and is easily passed back and forth between mother and baby.

4. A short tongue-tie

Limited tongue movement can prevent your baby from latching properly.

Unsure about the cause? A lactation consultant can help identify the problem quickly.

Treating nipple fissures: what really helps?

The most important things to remember:
1) You do not need to stop breastfeeding.

2) You also do not need to "power through the pain".

With the right approach, nipple fissures usually heal quickly.

1) Breast milk

After feeding, apply a few drops of breast milk to your nipple and let it air dry. Breast milk soothes and supports natural healing.

2) Nipple ointment

Choose an unscented, safe ointment (for example, based on lanolin or natural ingredients). Make sure you do not use products with irritating substances.

3) Air and rest

Let your nipples air dry as often as possible and avoid tight bras or abrasive materials.

3) Avoid soap

Do not use soap on your nipples in the shower; this dries out the skin and can slow healing.

4) Silver nipple cups

Read our blog on why silver nipple cups have healing power.

Tips for feeding with nipple fissures

Still having pain during feeding? These tips may help:

• Start on the less painful breast

• Switch feeding positions so the pressure is distributed differently

• Offer the breast a little more often so your baby feeds less ravenously

• Pump temporarily if direct feeding is too painful

If the symptoms persist, seek help from a lactation consultant. The right latch technique often makes a world of difference.

Preventing mastitis

Damaged nipples increase the risk of mastitis (breast inflammation). Bacteria can enter through cracks, or inflammation can develop due to milk buildup.

Watch for these signs:

• A hard, red, and painful area on your breast

• Fever or flu-like feelings

• Increasing pain

In that case, it is best to contact your GP. Timely treatment prevents it from getting worse.

With milk buildup, it is actually important to latch your baby onto the painful breast so the breast can be emptied properly.

Preventing nipple fissures: here’s how

Prevention is better than cure. Correct latching technique is crucial.

A good latch means:

• Your baby takes not only the nipple, but also a large part of the areola into the mouth

• The lips are turned outward

• You hear swallowing regularly

• Feeding feels comfortable (no sharp pain)

Unsure whether your baby is latching well? Ask for support. A small adjustment can bring major relief.