Sore nipples when breastfeeding: causes and relief
Many mothers feel some tenderness in the first days of breastfeeding. But pain that is sharp, lasts through the whole feed or leaves cracked nipples is not something you simply have to put up with. In most cases it can be fixed, and the most common cause is how the baby is attached to the breast.
What is normal and what is not
Some tenderness when the baby first latches on is common in the first week and usually eases within seconds as the feed settles. Breastfeeding should not cause lasting, toe-curling pain, blisters, bleeding or cracks.
If the pain continues through the feed, or gets worse after the first week, take it as a sign that something can be adjusted rather than a sign that you are doing it wrong.
Common causes
The most frequent cause is a shallow latch, where the baby takes mostly the nipple instead of a good mouthful of breast. Other causes include an awkward position, a baby who pulls off and re-latches a lot, a pump that does not fit well or is set too strong, and skin irritation from creams, pads or damp clothing.
Less often, the cause is an infection such as thrush, or a baby whose tongue movement is limited, sometimes called tongue-tie. These are worth asking a professional to assess if the usual fixes do not help, but they are not the first thing to assume.
Improving the latch
Bring the baby to the breast rather than leaning towards the baby. Aim the nipple towards the baby's upper lip and wait for a wide-open mouth. The chin should touch the breast first, with more of the areola visible above the top lip than below the bottom lip. The baby's body should be turned towards you, with head and body in a straight line.
If it hurts, break the suction gently by slipping a clean finger into the corner of the baby's mouth and try again. It is fine to re-latch as many times as needed. Trying a different position, such as laid-back or the football hold, often helps. See our guide on breastfeeding positions.
Easing soreness between feeds
Let your nipples air-dry after feeding or dab on a little of your own breast milk. Many find that a nipple balm helps soothe the skin, and soft breast pads or hydrogel pads can reduce friction. Change damp pads often and avoid harsh soaps on the nipples.
Do not stop feeding or pumping if you can avoid it, because long gaps can lead to engorgement. If one side is very sore, start the feed on the less sore side and ask for help with positioning on the other.
When to get help
Contact your health nurse (helsesykepleier), midwife or a lactation consultant if the pain does not improve within a few days of adjusting the latch, if the nipple looks flattened or creased after feeding, or if the skin is cracked or bleeding.
See a doctor if you have a fever, a red and hot area on the breast, or deep shooting pain in the breast after feeds, as these can point to infection. Also tell a professional if your baby is not gaining weight well or has few wet diapers.
Frequently asked questions
How long do sore nipples last when breastfeeding?
Mild tenderness often fades within the first one to two weeks. Pain that continues beyond that, or that gets worse, usually means the latch or position needs adjusting, so ask for help early.
Can I keep breastfeeding with cracked nipples?
Usually yes, and improving the latch is the best treatment. If the pain is severe, a health nurse or lactation consultant can help. Seek medical advice if you have a fever or signs of infection.
Is it thrush or just a poor latch?
A poor latch is far more common. Thrush is more likely if pain starts after a period of comfortable feeding, with shiny, pink or itchy nipples or burning pain after feeds. A health professional can assess you and your baby.
Does tongue-tie cause sore nipples?
It can in some babies, but not every baby with a short frenulum has feeding trouble. If pain and poor weight gain continue after the latch has been checked, ask a health nurse or doctor to look at it.
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