There
are several causes of sore nipples in the new mother. Most cases are
resolved by visiting a lactation consultant or discussing the
problem with the OB/GYN doctor. Occasionally a dermatologist is
consulted.
Most often nursing mother’s nipples
become sore when the baby latches on incorrectly. This makes them
hurt during nursing. Rotating the position of the baby relative to
the breast alters the area of pressure and allows the most irritated
areas to heal. Rather than holding the baby's body on her lap, the
mother can nurse lying down, with the baby's body laying along side
her, for example when the baby's head is nursing at the left breast,
the baby's feet are pointing toward the mother's left shoulder.
Follow each feeding with an emollient cream to the eroded cracked
area right after nursing.
Mastitis is a painful bacterial infection
of one breast. The skin is hot, red and tender. Small bumps around
the nipple that may be tender may be a milk plug or a milk blister.
These resemble white heads and can be exquisitely painful.
Candidiasis (also known as or yeast infection or thrush) of the
nipples is another cause. Unlike mastitis or milk plugs it almost
always affects both breasts. The nipples are bright red, inflamed,
almost sunburned in look and feeling. Moms feel like their nipples
are "on fire."
Unlike a cut or abrasion this hurts in
between feedings and even clothing brushing against the nipples is
very painful. The baby can pick up yeast infection from the mother
on its way through the birth canal or get it from taking
antibiotics. This can later pass from the infant's mouth to the
nipples. Unfortunately trying to prove yeast infection as the cause
of sore nipple is difficult. Taking routine cultures is close to
pointless as will not get a pure culture, but will most likely be
contaminated. Both baby and mom will need to be treated.
Ductal spasm is a deep pain below the
nipples at the tail end of the feeding and for about an hour after
the feeding. There is no nipple pain, irritation or inflammation.
Sometimes this pain will respond to hot wet compresses. Often this
will resolve after several weeks, but it may go on longer.
Moms with a history of Raynauds phenomenon
experience nipple blanching. Immediately after breast-feeding the
nipples turn white. It is worse if the mom has an oversupply of milk
leading to the infant biting down to stem the flow. Nipple blanching
is often relieved by hot compresses immediately following the
breast-feeding. Medications such as Procardia and Nitropaste have
also been used for this.