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.

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