Sore nipples and nipple infections

Getting help for sore nipples and nipple infections

Your midwife, child and family health nurse or GP or the Australian Breastfeeding Association (ABA) can support you with breastfeeding your baby. They can also help you find a lactation consultant if you need one.

An ABA counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268 or use ABA LiveChat.

This article covers sore and damaged nipples and nipple infections. If you’re having other issues with breastfeeding, you could check out our articles on mastitis and blocked milk ducts or breast inflammation, breast refusal and biting, how to increase supply and how to manage oversupply and engorgement.

Sore nipples caused by babies not attaching properly

The most common reason for sore nipples or damaged nipples is your baby not attaching properly to your breast.

You can expect some tenderness in the first few days or weeks of breastfeeding when your baby first latches onto the breast, but this should settle as the milk flows. Breastfeeding shouldn’t be painful.

If you’re in pain from sore nipples:

Seek help from a child and family health nurse, a midwife, an ABA breastfeeding counsellor or a lactation consultant.
Try a different attachment method, either baby-led attachment or mother-led attachment.
Try a different breastfeeding position, like the cradle position, underarm position or lying down position.

More options for sore nipples

If you’ve checked your baby’s attachment and you still have sore nipples, it helps to know that the problem of sore nipples doesn’t usually last. And there are more things you can try.

Before breastfeeding

Offer a feed before your baby is crying with hunger. A calmer baby will be gentler on your nipples. Your baby will give you cues that they’re hungry.
Try to trigger your let-down before your baby attaches to the breast. To do this, look at your sleeping baby, take slow and deep breaths, think about a tender moment, or massage your breast while gently rolling your nipple between your fingers. The pain will usually ease when your milk is flowing.

During and straight after breastfeeding

Start the feed on the breast that’s less sore.
If you need to take your baby off the breast, break the suction first by inserting your little finger into the corner of your baby’s mouth, between the gums. Gently take your baby off the breast.
Check your nipples at the end of each feed for signs of damage. They might look squashed, or you might see cracks. If you think your nipples are damaged, see your midwife, GP or child and family health nurse or talk to an ABA counsellor.
Hand-express a few drops of breastmilk at the end of a feed and spread it over your nipples.
Air-dry your nipples after breastfeeding.

Between breastfeeds

Change breast pads often to keep your nipples dry. Avoid using shampoos and soaps on your nipples.
Try applying purified lanolin ointment. Always speak to your midwife, GP, child and family health nurse or lactation consultant before using any nipple products, and use only a small amount as directed.
If your nipples are very sore and you’re waiting to get help, express your milk either by hand (the gentlest method) or with a good-quality breast pump on a gentle setting. Use well-fitting breast pump shields. Washable shields can be softer on sore nipples than disposable ones.
Feed your milk to your baby by cup or spoon until your nipples feel better.

Teats, bottles, dummies and nipple shields

If you can, avoid using teats, bottles or dummies. Babies need to suck differently on breasts compared to teats, bottles and dummies. And babies can get confused if they’re being offered teats, bottles and dummies in the early days of breastfeeding.
Work with a lactation consultant or an ABA counsellor if you want to try nipple shields. They might help with sore nipples in the short term, but they can sometimes create more problems than they solve.

If the soreness doesn’t get better each day, it’s worth talking to an ABA counsellor, a midwife or your child and family health nurse. They might suggest that an experienced lactation consultant examines your baby’s mouth. There could be a tongue tie or something else about the shape of your baby’s mouth that’s affecting their ability to breastfeed.

Even if you’re finding it too painful to feed your baby, you still need to keep your milk moving by expressing it. If you don’t remove milk regularly, your breasts might become engorged and you’ll be at risk of mastitis. Not removing milk regularly will also reduce your milk supply.

Nipple infections

Sore nipples and shooting pain in the breast that develops after a period of comfortable feeding are most likely caused by a bacterial infection (Staphylococcus aureus or ‘staph’), thrush infection (Candida albicans) or both. In this case, talk to your GP.

It can be hard to diagnose whether bacteria or thrush is causing the problem. Sometimes women might develop nipple thrush after they’ve had a course of antibiotics.

Your GP will prescribe your treatment depending on whether they suspect thrush or a bacterial infection. Your treatment might involve oral gel or drops, ointments or antibiotics. Some GPs might prescribe a combination of treatments for your nipples.

Nipple infections can be passed back and forth between mother and baby. If you have a nipple infection, both you and your baby will need treatment.