Sore Nipples— Prevention and Treatment

Shallow latch, tongue thrusting, short frenulum, using a finger to make unnecessary airway or the improper removal of baby
Cracked nipples can provide an entrance point for bacteria leading to mastitis

Use pump or hand express to start flow of milk so that baby doesn't need to suck as hard
Mother should be comfortable in arm chair with knees higher than hips using a foot stool
Baby should be supported on pillows with baby's tummy facing mother's tummy at breast level
Encourage deep and proper latch with infant held close to allow baby to focus on milk removal rather than having to hold nipple in mouth
Pull down on baby's chin while latched to increase depth of latch or to pull out lower lip
Alternate positions with each feeding to reduce stress to same area of nipple
Feed baby before overly hungry
Detach baby to release suction by inserting clean finger over baby's gum

During daily shower— rinse breasts with water; avoid soap or washcloth
Optional bra should be cotton; avoid constrictive tight material and underwires which may lead to plugged ducts
Cotton nursing pads are preferable to pads with plastic liners which may lead to thrush infection

Create a comfortable environment using music, shoulder massage and relaxation techniques
Hand express to stimulate let down; massage breast while nursing
Nurse on least sore side first when infant is most hungry
Express milk to nipple and areola after feeding and allow to air dry
Apply pea-sized amount of 100% pure lanolin to nipple (contra-indicated if allergic to wool)— do not wash off before next feeding
May leave flaps down on bra between feedings or breast shells may be worn to keep fabric off sensitive tissue
Seek advice from a Certified Lactation Consultant (IBCLC) if pain persists