Saturday, February 26, 2011

Breastfeeding and Nipple Soreness




How do you get sore nipples?

It is not uncommon to have sore or tender nipples in the first few days of breastfeeding. The tenderness may be greatest when your baby first latches onto the breast but it should lessen as the feeding continues. The tenderness is usually at its worst between 3 to 5 days after your baby is born. And, it usually doesn't last longer than the 1st week. Nipple soreness lasting beyond the first week is not normal. Soreness that interferes with feedings or continues throughout a feeding is also not normal. And, it is not normal to have skin breakdown like cracks, blisters, bruises, or bleeding on the nipple or areola. The areola is the dark area around the nipple.
  • Nipple soreness is usually caused by holding the baby incorrectly or by how your baby latches-on. Your baby's suckling pattern could be incorrect. Then, you may also find yourself postponing feedings because of the soreness. And, this may limit the amount of milk your baby gets. So, your overall milk supply could also decrease.
    Infant Feeding Breast Feed Latch-on 2 Incorrect Positions
    Picture of incorrect infant latch-on positions
  • Nipple pain can prevent or slow your let-down reflex. This may cause excess milk to be left in your breasts so your breasts become engorged (overfull). Engorged breasts get so full and tight, your baby has trouble latching-on to your nipple. Incorrect latch-on or an incorrect sucking pattern may make sore nipples even worse. This may be caused by a tight, full areola with a flat nipple.
  • A bacterial or yeast infection of the nipples and areola can cause healing of cracked nipples to take longer.

What can I do to prevent sore nipples?

  • Use only warm water when washing your breasts. Avoid soap and lotions or creams that have alcohol. But, you can put a thin layer of lanolin-based ointment on your nipples and areola after feedings. And, do not use plastic-lined bras or bra pads. Also, change your bra and bra pads as soon as possible when they get wet in order to keep your nipples dry.
  • Relax and gently massage your breasts before a feeding to help your milk let-down.
  • Carefully watch your baby's suckling pattern at the breast. Position your baby correctly at the breast; chest to chest, nose to breast. Make sure your baby opens his mouth wide to properly attach to your breast. His mouth needs to be on the areola well behind the nipple (1/2 to 1 inch). Ask your caregiver for the CareNotes™ handout about how to position and attach your baby to the breast.
  • Release your baby's suction before you take him off the breast. And, you may want to leave your breasts open to the air for a few minutes after each feeding. Express a small amount of breastmilk and massage it onto the nipples and areola.
  • Breastfeed your baby often, like 8 to 12 times in 24 hours.
  • Express some breastmilk before feeding if your breasts become engorged and your baby is having trouble latching-on. This softens the nipple and areola so that he can correctly attach and suckle at your breast. Ask your caregiver for CareNotes™ handout about the difference between breast fullness and engorgement.

What do I do if I get sore nipples?

Talk with your caregiver, a Lactation Consultant, or an LLL (La Leche League) Leader to help find out what is causing your sore nipples.
  • Breastfeed on the least sore side first.
  • Wear breast shells inside your bra to keep clothing and wet breast pads off your nipple. This helps prevent further irritation and pain.
  • Pump with a hospital grade, double electric breast pump at least 8 times in 24 hours if the nipple soreness is severe. This helps your sore nipples heal faster. You may only need to pump for 1 to 2 days.
  • Call your caregiver for pain medicine that can be taken while breastfeeding.

When should I call my caregiver?

Call your caregiver if you have any of the following problems.
  • Shaking chills or a temperature over 101 degrees F (38.4C).
  • Headache or muscle aches.
  • Pain and redness in one or both breasts. This may mean that you have a breast infection, which needs treatment. Shooting pains in your breasts during or after feedings may be signs that you have a bacterial or yeast infection.
  • You feel a lump in your breast
  • Nipples and areola that are red, swollen, itchy, burning, or have cracks lasting longer than 1 week.
  • Unrelieved engorgement (overfull breasts) for greater than 48 hours.

Can my baby's caregiver help me if I have breastfeeding questions or problems?

Ask for information about breastfeeding and make sure caregivers know that breastfeeding is important to you. Ask your caregiver for the name of a Lactation Consultant. This person is specially trained to help women breastfeed their babies. Also, ask caregivers about a breastfeeding class before your baby is born. Or, call your hospital for more information. Breastfeeding support groups can also help you learn about breastfeeding your baby. Call or write one of the following organizations for more information.
1400 N. Meacham Rd Schaumburg IL 60173-4808
La Leche League International
847 519-7730
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