management of nipple pain/soreness
Last reviewed 01/2018
Advice mothers on how to improve the baby's position and attachment since in most cases when the baby is well attached the pain decreases
- breastfeeding should be continued
- nipple shells or nipple shields have not been shown to be effective (1)
In cracked nipples, in addition to improving attachment a thin smear of white soft paraffin could be used
- should be applied only to the abrasion
- routine use of creams to prevent nipple trauma or pain is not recommended (2)
The following can be followed to prevent or soothe sore nipples:
- dry the nipples before getting dressed
- changing the breast pads at each feed (if possible use pads without a plastic backing)
- avoid soap since it dries the skin
- wear cotton bras to improve air circulation (3)
In patients with persistent nipple pain despite the above measures, suspect an infection which may be due to:
- candida infection
- bacterial infection - signs such as a yellow discharge or a wound in patients with persistent nipple cracks, a topical antibiotic ointment may be used.
Reference:
- 1. Hoddinott P, Tappin D, Wright C. Breast feeding. BMJ. 2008;336(7649):881-7
- 2. Guidelines and Audit Implementation Network (GAIN) 2009. Guidelines on the treatment, management & prevention of mastitis
- 3. NHS local 2010. Common breast feeding problems