SORE or CRACKED NIPPLES

The tenderness, soreness, and cracking in your nipples, usually occurring during the first few weeks of breastfeeding.

WHAT CAUSES THEM?

Poor breastfeeding positions or a baby with a very strong suck, can cause sore breasts after pregnancy and even cause nipples to crack.

WHAT YOU NEED TO KNOW?

If nipples could scream, this is when they'd do it. Soreness and tenderness can make you dread the next feeding — and even the next suck — but the situation does improve fairly rapidly, usually as you get the hang of breastfeeding and proper positioning (and as your nipples — and tolerance — toughen up). Many women also experience cracking or bleeding, which is also temporary and usually responds well to some simple treatments.

WHAT YOU CAN DO ABOUT THEM?

• Make sure your baby is properly positioned and has a proper latch on your areola, not your nipple.
• Make sure your baby is always facing your breasts, but try varying your nursing position. This means that a different part of your nipple will be compressed each time.
• Always try to use both breasts at every feeding, even if it's not for very long. If one breast is sorer than the other, nurse from the less sore one first. If your baby is very hungry, she'll tend to suck more vigorously at the beginning of the feeding. Avoidance, in this case, won't work — and will actually make matters worse.
• Tension might hinder your letdown. Less milk, unfortunately, means that your baby will have to suck harder to get it, so take a few minutes to relax before you breastfeed. You can also express a few drops of milk to get things going before you even put baby to breast.
• Don't be so quick to button up. Briefly expose your nipples to the air after each feeding.
• When it comes to your skin, climate matters. If you live in a dry area, try adding moisture. After a feeding, leave any milk on your breasts to dry instead of wiping it off. Or, express a few drops of milk and rub it into your nipples at the end of each feeding. If you live in a humid climate, try waving a warm hair dryer across your nipples for a few minutes after feedings.
• Regular tea bags soaked in cool water and applied directly sometimes help soothe sore breasts after pregnancy.
• Breast shells (not shields), can help your nipples heal by protecting them from scratchy clothing. Ask your practitioner or check online for sources.
• If you’re dealing with leaking breasts postpartum, change your nursing pads often.
• Don't use nursing pads with a plastic liner. These can trap moisture close to the skin and irritate sore nipples.
• Only use water to wash your nipples after pregnancy. Soaps and alcohols will irritate your skin.
• Talk to your doctor about using a cream, like a medical-grade lanolin, but avoid oily and petroleum-based products, like Vaseline.
• If you need it, ask your practitioner about over-the-counter pain medication for your sore breasts after pregnancy.
• Nipples that are cracked are more susceptible to infection, so pay close attention to how they look (if they start getting shiny and extra-bright pinkish red, you may have an infection). If you experience severe pain along with flu-like symptoms, call your practitioner.

WILL SORE NIPPLES AFFECT MY BABY?

Even though it's painful for you, having sore nipples won't affect your baby. However it's usually a sign that breastfeeding isn't going well. If your baby is not latching on properly, she may stop feeding before she's got enough milk. Warning signs that your baby is not feeding well are that she:

• is not putting on enough weight

•  spends a long time on your breast

•  wants to feed very often

•  makes clicking noises during feeds

• is unsettled after feeds

Rest assured that you can still breastfeed, even though your breasts are sore. However, if your nipples are extremely sore after trying the above tips, talk to your midwife, health visitor or doctor and ask to be referred to a breastfeeding specialist. She will be able to watch what you are doing and put you on the right track.

As a breastfeeding mum, you can pretty much eat what you like. However, there may be times when you suspect that something in your breast milk is upsetting your baby. For example, your baby may have wind or there may be changes to her poo.

Your baby may also cry a lot, and not necessarily during the late afternoon and early evening, the times associated with colic. There are many causes of tummy troubles or fussiness in babies. But it's been found that traces of particular substances in breast milk do upset some babies.

If you suspect your baby is reacting to your breast milk, you may want to cut out some foods to see if it makes a difference. If you do decide to cut out some foods, make sure you're still getting a healthy, balanced diet.

It's also important that your baby gets the right treatment. See our tables for guidance about what to do.