Sore Nipples Breastfeeding: Causes, Treatment & Prevention

What Are the Symptoms of Sore Nipples During Breastfeeding?

Symptoms of sore nipples include pain when the baby latches on or during feeding, cracked or bleeding nipples, blisters or open wounds on the nipple, and nipples that appear flattened, pinched, or misshapen after nursing. Mild tenderness in the first few days is normal, but severe or increasing pain indicates a problem.

Sore nipples during breastfeeding can range from mild discomfort to severe pain that makes nursing extremely difficult. Understanding the symptoms helps you identify the problem early and take corrective action before significant damage occurs. While some tenderness is expected in the first few days as your nipples adapt to breastfeeding, persistent or worsening pain is not normal and should be addressed.

The timing and nature of the pain provide important clues about the cause. Pain that occurs primarily at the beginning of a feed and improves as the baby settles into nursing may indicate sensitivity that will resolve as your nipples toughen. However, pain that persists throughout the feed or gets worse over time suggests an ongoing problem, usually with how the baby is latching onto the breast.

Visual changes to the nipples are another important indicator. After a good feeding session, your nipple should look similar to how it did before—round and normal in color. Changes in shape or color suggest that the nipple is being compressed incorrectly during nursing, which leads to tissue damage over time.

Common Symptoms You May Experience

The symptoms of sore nipples can vary in intensity and presentation. Some mothers experience primarily pain without visible damage, while others develop obvious wounds. Here are the most common symptoms to watch for:

• Pain during latching: Sharp pain when the baby first attaches to the breast, which may or may not subside during the feed
• Pain throughout feeding: Continuous discomfort or pain that lasts the entire nursing session
• Cracked nipples: Visible splits or fissures in the nipple tissue, often appearing as lines or cracks on the surface
• Bleeding: Blood on the nipple, in expressed milk, or on the baby's lips or mouth after feeding
• Blisters: Fluid-filled or blood-filled blisters on the nipple or areola
• Nipple blanching: Nipples that turn white or pale during or after feeding, indicating restricted blood flow
• Misshapen nipples: Nipples that appear flattened, wedge-shaped, or "lipstick-shaped" after nursing

Signs of Infection to Watch For

Open wounds on nipples can become infected if bacteria enter the damaged tissue. Infection requires prompt medical treatment. Warning signs of nipple infection include increasing redness and swelling around the nipple, pus or yellow discharge from the wounds, red streaks extending from the nipple toward the breast, fever or flu-like symptoms, and pain that worsens rather than improves with treatment.

What Causes Sore Nipples When Breastfeeding?

The most common cause of sore nipples during breastfeeding is an incorrect or shallow latch, where the baby doesn't take enough breast tissue into their mouth. Other causes include tongue-tie in the baby, thrush infection, poor positioning, and the baby being too far from the breast. Understanding the cause is essential for effective treatment.

While sore nipples can feel discouraging, understanding the underlying cause is the first step toward healing. The good news is that in most cases, the cause is mechanical—related to how the baby attaches to the breast—and can be corrected with proper technique. Once the cause is addressed, healing typically happens quickly.

The breast and nipple are designed for breastfeeding, and when everything works correctly, nursing should not be painful. Pain is a signal that something isn't quite right, whether that's the baby's positioning, their ability to latch effectively, or an underlying condition that needs treatment. Identifying the specific cause allows for targeted intervention.

In some cases, multiple factors may contribute to nipple soreness. For example, a mother might have a mild latch issue that becomes more problematic when combined with the baby's tongue-tie. Working with a lactation consultant can help identify all contributing factors and develop a comprehensive solution.

Incorrect Latch: The Primary Cause

The most common reason for sore nipples is an incorrect latch. When a baby latches correctly, they take a large mouthful of breast tissue, with the nipple positioned far back in their mouth near the soft palate. This protects the nipple from friction and compression. However, when a baby takes a shallow latch, taking only the nipple or minimal breast tissue, the nipple ends up against the hard palate where it gets pinched and rubbed with each suck.

A shallow latch creates friction damage similar to rubbing skin repeatedly against a rough surface. The nipple tissue, which is sensitive and not designed for this kind of friction, quickly becomes sore, red, and eventually cracked. Each feeding session compounds the damage because the underlying problem hasn't been corrected.

Signs that your baby may have a shallow latch include clicking sounds during feeding (indicating the baby is breaking suction), your nipple appearing flattened or wedge-shaped after feeding, the baby's lips being tucked inward rather than flanged outward, and visible more areola below the baby's bottom lip than above the top lip (it should be the opposite).

Baby's Position Relative to Breast

Even if the initial latch looks good, the baby's overall position can cause nipple problems. If the baby is positioned too far away from the breast, they may pull on the nipple as they try to maintain suction. This stretching and pulling causes tissue damage over time. Similarly, if the baby's body is twisted rather than aligned (ear, shoulder, and hip in a straight line), they cannot feed comfortably and may compensate by changing how they suck.

The ideal position has the baby's body pressed closely against the mother, tummy-to-tummy, with their chin touching the breast and their nose free for breathing. Their head should be slightly tilted back so they can swallow easily. When positioned correctly, the baby can take a deeper latch and feed more efficiently without damaging the nipple.

Tongue-Tie and Other Anatomical Issues

Some babies have anatomical variations that make latching correctly difficult. The most common is tongue-tie (ankyloglossia), where the tissue connecting the tongue to the floor of the mouth is shorter or tighter than normal. This restricts the tongue's movement, preventing the baby from extending it far enough forward to cup the breast and protect the nipple.

Babies with tongue-tie may also have difficulty staying latched, making clicking sounds as they repeatedly break and re-establish suction. Their tongues may appear heart-shaped when they cry, and they may not be able to lift their tongue to the roof of their mouth. While mild tongue-tie may not cause problems, significant restriction often requires a simple procedure (frenotomy) to release the tongue.

Thrush Infection

Thrush is a fungal infection caused by Candida yeast that can affect both mother and baby. When thrush affects the nipples, it causes distinctive symptoms including burning pain that continues after the feed, shiny or flaky appearance of the nipple skin, deep pink or red coloration, and itching. The baby may have white patches in their mouth that don't wipe away easily.

Thrush often develops after antibiotic use, which can disrupt the normal balance of organisms on the skin and in the body. Both mother and baby need to be treated simultaneously to prevent passing the infection back and forth.

What Can I Do Myself to Heal Sore Nipples?

To heal sore nipples, first correct the underlying latch problem. Apply expressed breast milk to nipples after each feed and let them air dry. Wash hands before nursing to prevent infection. Start feeding on the less sore side. Use purified lanolin or medical-grade nipple ointments if needed. Avoid soap on nipples and wear loose, breathable clothing.

The most important step in healing sore nipples is addressing the underlying cause, which in most cases means correcting the baby's latch. Without fixing the latch, treatments will only provide temporary relief while damage continues with each feed. Think of it like continuing to rub a blister—no amount of bandaging will help if the rubbing doesn't stop.

Once the cause is addressed, nipples typically heal remarkably quickly because they have a good blood supply and the skin regenerates fast. Most cracked nipples begin to improve within 24-48 hours of achieving a better latch, and fully heal within a week. In the meantime, several strategies can promote healing and reduce discomfort.

It's worth noting that you don't need to stop breastfeeding while nipples heal. In fact, continuing to breastfeed (with a corrected latch) helps maintain milk supply and prevents other problems like engorgement. However, in severe cases, you may need to temporarily rest the nipples by expressing milk and feeding by other methods.

Practical Tips for Healing

Here are evidence-based strategies for promoting nipple healing while continuing to breastfeed:

• Wash your hands before each breastfeeding session to reduce the risk of infection entering any damaged skin
• Apply expressed breast milk to your nipples after each feed and allow them to air dry—breast milk contains antibodies and healing factors
• Start feeding on the less sore side first—babies suck more vigorously at the beginning of a feed when they're hungriest
• Try different breastfeeding positions to change the pressure points on the nipple and reduce friction on damaged areas
• Use purified lanolin cream or medical-grade nipple ointments after feeding—these don't need to be washed off before the next feed
• Avoid washing nipples with soap as this removes natural protective oils and can worsen dryness and cracking
• Let nipples air dry when possible and avoid breast pads that trap moisture against the skin
• Wear loose, breathable clothing to prevent friction and allow airflow

When Nipples Need to Rest

Sometimes the damage is severe enough that continuing to breastfeed on the affected side prevents healing. In these cases, you may need to temporarily rest that nipple while maintaining milk supply by expressing milk. You can express by hand or with a breast pump, and feed the expressed milk to your baby using a cup, spoon, or syringe—methods that don't interfere with breastfeeding.

If your baby ingests a small amount of blood from cracked nipples, don't be alarmed. This is not harmful to the baby, although they may spit up slightly bloody milk or have darker stools. The important thing is to address the underlying cause so the bleeding can stop and healing can begin.

Cleaning Wounds Properly

Avoid using soap, alcohol, or harsh cleansers on damaged nipples as these can irritate the tissue and delay healing. You can clean nipple wounds gently with expressed breast milk, which has natural antibacterial properties, or with sterile saline solution (salt water) available from pharmacies. Pat dry gently rather than rubbing.

Using Nipple Shields

Nipple shields are thin silicone covers that fit over the nipple and areola during breastfeeding. They can provide a barrier that protects damaged nipples and may make feeding more comfortable while wounds heal. However, nipple shields should be used only as a temporary measure and ideally under the guidance of a lactation consultant.

The concern with nipple shields is that they can reduce milk transfer if not used correctly, potentially affecting the baby's weight gain and the mother's milk supply. They can also mask underlying latch problems rather than solving them. If you use a nipple shield, work with a lactation specialist to develop a plan for transitioning back to direct breastfeeding once healing is complete.

How Do I Achieve a Proper Latch to Prevent Sore Nipples?

For a proper latch, hold baby close with nose level to nipple. Wait for baby to open mouth very wide like a yawn, then quickly bring them to the breast chin-first. Baby should have a large mouthful of breast with lips flanged outward. More areola should be visible above the top lip than below the bottom lip. After feeding, the nipple should look round, not flattened.

Achieving a proper latch is the single most important factor in preventing and healing sore nipples. While it may take some practice, especially for first-time mothers and babies learning together, the basic principles are straightforward. Once you understand what a good latch looks and feels like, you can work toward it with each feed.

Remember that breastfeeding is a learned skill for both mother and baby. In traditional societies, women grew up seeing breastfeeding all around them and learned techniques naturally. In modern life, many women come to breastfeeding without this background knowledge. Seeking help from a lactation consultant or experienced breastfeeding supporter is not a sign of failure—it's a wise use of available resources.

A good latch should feel comfortable. While you may feel some pulling or tugging sensation, there should not be pinching or sharp pain. If the latch hurts, it's better to break the suction (by inserting a clean finger into the corner of the baby's mouth) and try again rather than enduring pain. Each painful feed causes more damage and teaches the baby an incorrect pattern.

Steps to Achieve a Deep Latch

Follow these steps to achieve a deep, comfortable latch that protects your nipples:

1. Position your baby correctly: Hold your baby close to your body, tummy-to-tummy. Their nose should be level with your nipple, not their mouth. Support their neck and shoulders with your hand—not the back of their head—so they can tilt their head back slightly.
2. Trigger the rooting reflex: Touch your nipple gently to your baby's upper lip or nose. This stimulates their rooting reflex and encourages them to open wide.
3. Wait for a wide mouth: Be patient and wait until your baby opens their mouth very wide, like a yawn. A small opening leads to a shallow latch.
4. Bring baby to breast chin-first: When the mouth is wide open, quickly bring the baby to your breast (not the breast to the baby). Lead with their chin so it touches the breast first, with their head tilted slightly back. Their bottom lip should land far from the base of the nipple.
5. Check the latch: Once latched, your baby should have a large mouthful of breast. Their lips should be flanged outward like "fish lips." You should see more areola above the top lip than below the bottom lip. Their chin should be pressed into the breast with nose free.

Signs of a Good Latch

When your baby is latched correctly, you should observe the following signs:

• Baby's mouth is opened wide with lips flanged outward
• Baby's chin is pressed into the breast
• You can see more areola above the top lip than below the bottom lip
• Baby's cheeks appear full and rounded, not dimpled or sucked in
• You hear swallowing sounds (especially after milk comes in)
• You don't hear clicking or smacking sounds
• The latch feels comfortable—tugging but not pinching
• After the feed, your nipple looks round, not flattened or misshapen

Common Latch Problems and Solutions

If you're struggling with latch, these common issues may be the culprit:

Baby latches on too shallow: If you notice the baby taking mostly just the nipple, try waiting longer for a wider mouth opening, or gently pressing down on the baby's chin as they latch to encourage them to take more breast.

Baby slides off during feeding: This often happens when the baby's body is too far from yours. Bring them in closer, ensuring their body is pressed against yours with no gap between you.

Nipple comes out flattened: This indicates the nipple is being compressed, usually because the baby's mouth isn't open wide enough. Break the latch and try again, waiting for a bigger mouth opening.

When Should You See a Doctor for Sore Nipples?

Seek medical care if nipple pain persists despite correcting the latch, if you see signs of infection (fever, pus, increasing redness), if you develop symptoms of thrush (burning pain, shiny nipples), if wounds don't heal within a week, or if pain is so severe that breastfeeding becomes impossible. A lactation consultant can help with latch issues.

While many cases of sore nipples can be resolved at home with improved latch technique and self-care measures, some situations require professional help. Knowing when to seek care ensures that problems don't escalate and that any underlying conditions receive appropriate treatment.

There are two main types of professional help to consider: lactation support and medical care. A lactation consultant (International Board Certified Lactation Consultant or IBCLC) specializes in breastfeeding support and can help with latch, positioning, and technique. A healthcare provider (doctor, midwife, or nurse) is needed for medical conditions like infections or suspected tongue-tie that may require treatment.

Don't hesitate to seek help early. Early intervention often prevents problems from becoming more serious and helps you get breastfeeding on track more quickly. Most areas have breastfeeding support services through hospitals, health centers, or community organizations.

When to See a Lactation Consultant

Consider consulting a lactation specialist if:

• You've tried to correct the latch yourself but pain continues
• You're unsure whether the latch looks correct
• Your baby has difficulty staying latched or makes clicking sounds during feeding
• You suspect tongue-tie or other anatomical issues
• Your baby is not gaining weight well
• You want professional guidance on using nipple shields or other aids

When to Seek Medical Care

Contact a healthcare provider promptly if you experience:

• Fever (temperature above 38°C / 100.4°F)
• Increasing redness, swelling, or warmth around the nipple or breast
• Pus or yellow-green discharge from nipple wounds
• Red streaks extending from the nipple toward the breast
• Symptoms of thrush: burning pain that continues after feeding, shiny or flaky nipple skin, deep pink or red color
• Severe pain that makes breastfeeding impossible
• Wounds that don't show signs of healing after one week of proper care

What Complications Can Develop from Sore Nipples?

Untreated sore nipples can lead to bacterial infection (requiring antibiotics), thrush infection (requiring antifungal treatment), mastitis (breast infection), early weaning due to pain, reduced milk supply if feeding decreases, and psychological distress. Most complications can be prevented with early intervention and proper latch correction.

While sore nipples themselves are uncomfortable but not dangerous, complications can develop if the underlying problem isn't addressed. Understanding potential complications helps motivate early action and ensures you know what warning signs to watch for.

The most significant concern is infection entering through broken skin. The nipple and areola normally host various bacteria that don't cause problems on intact skin. However, when there are cracks or open wounds, these bacteria can enter the tissue and cause infection. This is why hand washing before breastfeeding is so important.

Another consequence of persistent nipple pain is its impact on the breastfeeding relationship. Pain can cause mothers to delay or shorten feedings, which affects milk supply and the baby's nutrition. Some mothers may wean earlier than intended simply because breastfeeding has become too painful. Early help can prevent these outcomes.

Bacterial Nipple Infection

When bacteria enter damaged nipple tissue, infection can develop. Signs include increasing pain, redness and swelling around the wound, warmth to the touch, pus or discharge, and sometimes fever. Bacterial infections require antibiotic treatment prescribed by a healthcare provider. Most antibiotics used for these infections are compatible with breastfeeding.

Thrush (Fungal Infection)

Thrush can develop on damaged nipples, especially after antibiotic use or in mothers or babies who have recently had thrush elsewhere. Symptoms include burning, itching, or stinging pain that continues between feeds, shiny or flaky nipple appearance, and deep pink or red color. The baby may have white patches in their mouth. Both mother and baby need antifungal treatment simultaneously.

Mastitis

Mastitis is an infection of the breast tissue that can develop from nipple cracks that allow bacteria to enter, or from milk stasis (when milk isn't effectively removed). Symptoms include a painful, red, warm area on the breast, flu-like symptoms with fever and body aches, and feeling generally unwell. Mastitis requires prompt antibiotic treatment. Continuing to breastfeed or express milk is important to help clear the infection.

Impact on Breastfeeding

Pain is one of the most common reasons mothers give for stopping breastfeeding earlier than intended. When each feed becomes an ordeal, mothers naturally begin to dread nursing sessions. Some may start supplementing with formula to give their nipples a break, which can affect milk supply. Others may decide to wean altogether. These outcomes can usually be prevented with timely support.

How Can You Prevent Sore Nipples When Breastfeeding?

Prevent sore nipples by learning proper latch technique before or immediately after birth, getting early help if latch feels painful, checking nipple shape after each feed (should be round, not flattened), keeping nipples moisturized with breast milk, avoiding soap on nipples, and seeking support at the first sign of problems.

Prevention is always better than treatment, and most cases of sore nipples can be prevented with proper technique from the start. If you're pregnant, learning about breastfeeding positioning and latch before your baby arrives gives you a head start. If you've already started breastfeeding and are experiencing problems, it's never too late to get help and correct course.

The key to prevention is achieving and maintaining a good latch from the very first feeds. In the first days after birth, when both you and your baby are learning, take your time with each latch. It's better to relatch several times to get it right than to accept a painful latch that causes damage. Ask for help from the nurses, midwives, or lactation consultants available in your birthing facility.

Ongoing monitoring is also important. Even after you've established a good feeding pattern, changes can occur. Babies go through growth spurts that may change their nursing behavior. Illness, teething, or developmental changes can affect latch. Stay alert to any increasing pain and address it early.

Prevention Strategies

• Learn before birth: Attend a breastfeeding class or read about positioning and latch technique during pregnancy
• Get early help: Ask for breastfeeding support in the first hours and days after birth
• Don't accept pain: If the latch hurts, break suction and try again—pain means something is wrong
• Check nipple shape: After each feed, look at your nipple—it should be round, not flattened or misshapen
• Keep nipples moisturized: Apply expressed breast milk and let air dry after feeds
• Avoid irritants: Don't use soap, alcohol, or perfumed products on nipples
• Vary feeding positions: Changing positions distributes pressure on different parts of the nipple
• Treat problems early: At the first sign of damage, take action to correct the cause and promote healing