13 Causes of Breastfeeding Nipple Pain

This post may contain affiliate links. Please see my full disclosure for more information.

One of the most common reasons that new moms don’t want to breastfeed is breastfeeding nipple pain. As a mommy of two, I can tell you that this is totally valid. Breastfeeding (especially in the first few weeks) can really hurt.

However, there are a few ways you can prevent breastfeeding nipple pain and go on to breastfeed your baby if that is what you want!

During the first week, it is normal to experience sore nipples, especially if this is your first time breastfeeding. This should only last for a few seconds while baby is latching.

If the pain persists throughout the feeding, this could indicate a problem. In order to treat nipple pain or soreness, you need to find out the reasons why it is happening. You can then consult your physician or a lactation consultant in order to find out what is causing the pain.

Transient pain is what you feel during the beginning stages when the baby first latches and your nipples are trying to get used to your baby’s sucking.

You may experience the following:

Latching pain – Usually latching pain will only last for about 30 seconds but it won’t continue as feeding goes on or in between the feeds.
After feeding soreness – After breastfeeding, your nipples will still look the same – not pinched, no cracks/blisters, and not bleeding, but may be sore

These are normal and will diminish as you continue to nurse your baby.

If you feel the following below, it may be a more serious issue and a consultation is needed:

Your nipples become cracked and skin is damage or bleeding after nursing
Pain is excruciating
Pain in between your feeds
Pain all throughout the feeding
Pain that lasts for weeks

Causes of breastfeeding nipple pain:

Bad latch (shallow latch)

A proper latch means your baby should be putting your entire nipple and some of the areola into his/her mouth. If baby is just sucking on the nipple, it could lead to pain, and then bleeding and cracked nipples.

You can help your baby latch on properly by cupping your breast with your hand and then gently touching your baby’s nose with your nipple. This will let your baby open their mouth wide and you can then bring their head to your breast so that they can do a deep latch.

You can also ask a lactation consultant for the best way on how to get your baby to get a deeper latch.

Over time as you get used to breastfeeding, you can already determine if your baby did a good latch or if they did at first and then started to slip. When this happens, you can always break your baby’s latch using your finger and re-latch them again.

Thrush

This is also known as a yeast or fungal infection. This can either manifest on the mother, specifically on your breasts, and also on the baby. The bacteria involved is called Candida Albicans.

Naturally, we have this fungus in our bodies and they are harmless. Sometimes, they could grow and spread turning into an infection.

When you are breastfeeding, the chances of candida developing into an infection is greater since there is moisture, warmth, and even sugar from the milk involved.

Signs of thrush:

Itchy/burning nipples
Cracked nipples that don’t heal
Sore nipples
Your nipples could look scaly, flaky, red, or have white spots/blisters
Baby can have white patches or small blisters on their tongue, around the cheeks, gums, or mouth
Baby will be fussy
Your baby could have a diaper rash that won’t be healed by diaper creams or powders

You can treat thrush with prescription medicine although there are also some over the counter ones as well as home remedies you can try. Especially if your condition is not getting any better, it is best to consult your physician.

Position during breastfeeding

When you are breastfeeding, it is important to get into a good position with your baby. Baby’s mouth should be positioned a little bit higher than your nipple. This is because if your baby’s mouth is lower than your nipple, it could cause them to pull and result to nipple pain as well as a shallow latch.

Vasospasm

This condition is when blood vessels narrow due to breastfeeding with a shallow latch. This usually causes the nipple to blanch. Vasospasm happens when your baby compresses the nipple during breastfeeding.

Signs of vasospasm:

Sore nipples during breastfeeding
Nipples could whiten after a feed
Deep breast pain
Nipples that are deformed
Burning and itching pain felt in between feeds

Ways you can prevent vasospasms:

Being active to get your blood circulation going
Avoid alcohol, caffeine, and nicotine
Keeping warm
Get help from a lactation consultation

Postpartum hormones

Sometimes, the hormones in our bodies postpartum are enough to cause painful and sore nipples. This will be more amplified if you are still a newbie to nursing. On the bright side, as time goes on, it will slowly get better and less painful so hang in there!

Milk blisters

A milk blister is a clogged or blocked milk duct that’s found on the surface of the nipple. This is due to a tiny amount of skin growing over the milk duct. It could look white, clear, or yellow. It could look like a small pimple or a white blister.

They are usually referred to as a nipple blister or milk bleb. Milk blisters usually happen if there’s an oversupply of milk, baby having a bad latch, tongue tie, thrush, or if there is pressure on the breast.

If you are breastfeeding and have a milk blister, it can be really painful. It can take weeks for your nipples to heal on its own.

Here’s how you can treat milk blisters:

Before breastfeeding, soak your nipple in saline solution. Apply a warm compress directly to your nipple.
Because of the warmth, the blister can loosen and you can start to gently scrape it using a warm washcloth or your fingers (make sure they are clean)
Start to nurse or pump in order to clear the duct
After breastfeeding, soak the nipple again in saline solution. Apply a bit of expressed breast milk on your nipple and air dry.
You can then apply a nipple cream/ointment after.
You can repeat this process until it has healed.

Infection

If you have cracked nipples it can lead to an infection happening. This can also lead to mastitis. It is important that if you feel that you are experiencing the symptoms below, to get help right away. You could be given antibiotics in order to treat the infection and prevent it from getting more serious.

Symptoms of a breast infection:

Painful lump in the breast
Puss discharges from the nipple
Swelling in the breast
Breast is warm to the touch
You could feel some burning and pain while you breastfeed
Fever
Flu-like symptoms
Skin redness

If you have damaged nipples, you can wash them with ordinary mild soap daily so that the bacteria can be reduced. Take note that if your nipples are healthy, there is no need to wash them with soap.

Lip/Tongue tie

A lip or tongue tie is when the connective tissue under the tongue called frenula is tight or is in a position that inhibits baby to move their tongue or flare out the lip.

If your baby has this condition, they may have trouble latching on properly and this could lean to nipple pain. It can also cause issues like low weight gain, clogged ducts, mastitis, and low milk supply.

Consult your physician if you suspect that your baby has a lip or tongue tie so that it can be corrected and addressed right away.

Symptoms of a lip or tongue tie for babies:

Bad latch
Choking or coughing at the breast
Chewing/biting the nipple
Fussy at the breast
Clicking sound during breastfeeding
Sliding off the breast
Cannot maintain a deep latch
Baby gets tired/fatigue after nursing for a few minutes
Baby can’t swallow properly after let down
Colic
Slow weight gain
Gas and reflux

Symptoms of a lip or tongue tie for moms:

Nipple pain
Nipple looks pinched after nursing
Breast pain
Low milk supply
Mastitis or clogged ducts
White stripe on the nipple after breastfeeding

Breast pump trauma

If you don’t use a breast pump properly, you may end up damaging your nipples. It’s important to also to check if the flanges/ nipple shields are not too small since that can cause trauma to your nipples.

Engorged breasts

If your breasts are really full, it can get tight and your nipple can flatten out. This will then make it harder for baby to latch on properly. Try to massage your breast and apply some heat before feeding. You can also express a bit with your hands.

Nipple shape

If you have very large nipples, or if they are inverted or flat, it can be harder for your baby to latch on. There are different ways you can address this by using nipple shields for example. It is best to consult your lactation specialist to help you find the best position for you and your baby.

Allergies

Another reason for nipple pain/soreness is due to any food allergies you might be experiencing or if you have some reaction to a nipple cream.

Skin conditions

If you have eczema, dermatitis or psoriasis, consult with your physician on what the best type of medication is to address this and what is also safe for breastfeeding.

If you are feeling breastfeeding nipple pain you may want to consult your physician. Listen to your body and it will tell you what’s normal and what isn’t. If you don’t’ address the pain, it may lead to bleeding or cracked nipples.

In order to treat the issue of breastfeeding nipple pain, you need to find the root cause and address it. When you have an understanding of what is causing your nipple pain, you can create an action plan to overcome it.