Sore or cracked nipple

Unfortunately most mothers will experience some degree of pain or discomfort during their breastfeeding journey. Pain is not normal and shouldn't be accepted. There usually is an underlying reason for it. Often it is the latch that needs improving, sometimes an undiagnosed or untreated tongue tie, occasionally it can be trush, etc. it is a good idea to seek professional help if you experiece nipple pain in order to find the cause and deal with it. Ideally breastfeeding should be painfree and an enjoyable experience for both, mother and baby. If the mother has to endure discomfort she is much more likely to give up breastfeeding well before the recommended duration.

A good attachment means that the nipple is moving against the baby's soft palate. if a poor, shallow latch is present, the nipple will not be far enough in baby's mouth and therefore is rubbing against the hard palate. In a lot of cases a Tongue Tie is responsibe for the baby's inability to open his/her mouth wide enough to manage a good latch and to maintain it for the duration of the feed (baby will often loose the vaccum, slip off the breast or unlatch frequently).

In a lot of cases a flattened, misshapen nipple can be observed, which is a sign that the nipple was compressed by tongue and hard palate.

In case of pain it is always advisable to seek the professional help of a Board Certified Lactation Consultant (IBCLC) or a qualified Breastfeeding Counsellor to find the reason for the pain. 

During breastfeeding

• Breastfeed from the intact or less injured breast first as baby will tend to feed more gently on the second side offered
• Trying out different breastfeeding positions to find the most comfortable.
• It is very important to keep emptying the breasts, so if breastfeeding is too painful, keep expressing in order to avoid mastitis and to maintain the milksupply. 

After breastfeeding

• Soak nipples in warm saline or use a squirty bottle to soak the nipples, pat them dry gently
• Expressed breastmilk applied to the nipples promotes healing. 
• “Moist wound healing” is a concept used in surgical wound healing, apply a medical grade lanolin ointment (e.g. Lansinoh) or a hydrogel dressing (e.g., Multimam, Jelonet, Novogel).
• If you have thrush, follow the saline soak with an antifungal creme (Daktarin)
• If needed, apply an antibiotic ointment (e.g. Bactroban) sparingly after each feed.