Symptoms
- The mother has severe nipple pain when the baby is suckling.
- There may be a visible fissure across the tip of the nipple or around the base.
- The nipple may look squashed from side-to-side at the end of a feed, with a white pressure line across the tip.
Cause
- The main cause is poor attachment.
- This may be due to the baby pulling the nipple in and out as he or she suckles, and rubbing the skin against his or her mouth; or it may be due to the strong pressure on the nipple resulting from incorrect suckling.
Management
- The baby can continue breastfeeding normally.
- There is no need to rest the breast – the nipple will heal quickly when it is no longer being damaged.
- Always start feeding with a healthy breast that does not have an injury.
- Enhance the baby’s position and attachment, demonstrate to the mother the criteria for good attachment and ensure her understanding.
- After feeding, let the nipples air dry to speed up healing.
- Anti-sore cream containing lanolin can be applied.
- Applying cold packs between feeds can help reduce pain and swelling.
- If nipple pain is preventing the baby from emptying the breast, a breast pump can be used to empty the breast to give the nipple a chance to heal and prevent engorgement.
