lactation Archives - Nurtured Birth

Sore nipples are one of the more common concerns new mamas face when beginning their breastfeeding journey.

Breastfeeding is a wonderful, natural way for a mother to bond with her baby, and breast milk is recommended as the only source of food for a baby’s first six months of life.

Whilst the production of breast milk occurs naturally, the art of breastfeeding doesn’t always go smoothly.

For many mothers the experience is simple and straightforward, but for some it can become a painful ordeal.

Breastfeeding is a learned skill for both mother and baby, and there are bound to be some hiccups at the beginning. Sore nipples are often dismissed as part of the process but pain definitely isn’t something new mamas should ‘put up with’. Sore nipples can be so painful that a mother gives up breastfeeding altogether.

Find out what you need to know about sore nipples and breastfeeding, and what we recommend for prevention and support.

Pre-pregnancy breast soreness

Breasts, areolas and nipples come in all shapes and sizes and will change throughout a woman’s life cycle, from adolescence through to menopause. We need to have an awareness of what is normal for our breasts by doing regular breast checks so we can spot any unusual changes quickly.

Breast soreness is very common. It affects most women at some time in their lives, usually in the form of swelling, lumps, bumps, general aches and soreness. Commonly felt at varying times of the menstrual cycle, breast soreness is usually regarded as normal. The soreness will vary from woman to woman, so it is important to be aware of what is normal for you.

If there is any unusual pain, extreme pain, or changes in the breast tissues (with or without pain) it needs to be explored further. This could be due to other factors such as cysts, tumours or mastitis. Seek advice from a medical professional for further investigation into the source of pain and treatment.

Pregnancy breast soreness

During pregnancy, your breasts undergo many changes, influenced by hormonal fluctuations.

During the first trimester your breasts may feel generally sore and tender. The breasts often increase in size and as the pregnancy moves forward the areola and nipples will usually darken and become larger.

It is important to make sure to be fitted with the right style and size of bra during pregnancy, to prevent not just soreness but long-term damage to the breast tissue.

During the third trimester the breasts will begin to make colostrum in preparation for milk supply for the soon to be born baby. This can be seen as a shiny, clear discharge from the nipples.

Some women may hand express this colostrum after consultation with their midwife, obstetrician or doctor. In certain situations babies need supplementation after birth and a supply of colostrum in the freezer can be used instead of formula.

Breastfeeding soreness

Breastfeeding is biologically the normal way to feed mammal babies and the production of milk (lactation) occurs naturally after giving birth. Breast milk contains everything your baby needs for nutrition for the first six months of life.

Breastfeeding begins soon after birth, often with mum bringing the baby to her breast within minutes after birth. Babies left on their mothers bellies after birth have an innate instinct to seek out the breast, and will crawl up to the nipple.

In the first few days, your breasts will produce colostrum and this provides everything your baby needs. Within a few days, your milk ‘comes in’ and changes in volume and composition. This can cause some discomfort as breasts become full and engorged, and your baby is increasingly hungry and more demanding.

Breastfeeding shouldn’t be painful. But in the initial few weeks, at the beginning of a feed, there may be some discomfort when the baby first attaches to the breast. The sensation should subside within a short time and as the feed continues it should not be painful.

There can also be other issues such as engorgement, mastitis, nipple vasospasm, thrush and other infections. Nipples may appear bright pink or red in colour, bleeding, dry, flaky, or have a white rash (thrush).

Causes of sore nipples when breastfeeding

Sore nipples most often occur if the baby doesn’t have the proper attachment or ‘latch’ to the breast.This can cause cracking, splitting and bleeding of the nipple. Sometimes these sores are obvious, but small cracks can be hard to see, even if very painful.

There can be other issues such as a baby with tongue tie, incorrect use of breast pumps, or medical conditions such as dermatitis or an infection. In these cases it is important to seek help from a qualified professional to properly diagnose the problem and offer the right course of treatment.

Even if breastfeeding is going well problems can still arise. Nipple soreness can occur if mum or baby become complacent about latch, the baby has a growth spurt causing a sudden increase in feeds, or baby begins teething.

What can be done to help breastfeeding and sore nipples?

Even if you have breastfed before, breastfeeding each baby is new and can take some adjusting to. Being prepared for breastfeeding before you have your baby is a good foundation to understanding what can go wrong and what to do about it.

Nurtured Birth recommends Born To Breastfeed, a comprehensive and accessible breastfeeding guide for mothers, answering all your questions and providing support for challenges. You can purchase this through Nurtured Birth’s shop here.

Seek advice straight away! The best person to help is a lactation consultant. They will have specialist training and knowledge on breastfeeding issues. Your midwife, maternal & child health nurse, postnatal doula or paediatrician can also provide some support.
Consider attending breastfeeding classes during pregnancy to prepare yourself and your partner. You can also make contact with a lactation consultant so they will already be on hand to assist once the baby is born.
Try to feed on the baby’s first cues of being hungry, not waiting until they are crying. You can try putting the baby to the breast more often, expressing some milk prior to feed and offering the less sore side first.
Finding the proper positioning while feeding. Getting the right set up of chair, pillows, baby’s position to allow for correct attachment to the breast.
Keep nipples dry between feeds. Make sure to change nursing pads frequently and use 100% cotton for best airflow, not plastic lined ones.
After a feed leave some fresh breast milk on your sore nipples and keep them open to air for a few minutes. Pat dry gently.
Products like the BodyICE Breast Pads provide relief for sore nipples. You can purchase these cleverly designed pads that fit into your bra through Nurtured Birth’s website here.
Soothing products to assist with the pain and healing: after a feed apply a saltwater rinse to the nipple or try a warm cloth compress. A lanolin ointment that is 100% medical-grade is also safe to use on your nipples after a feed.
Check your expressing technique – some electric pumps can be too harsh and may need to be adjusted. Sometimes a manual pump or hand expressing can be gentler on sore nipples.
Nipple shields can be used for short periods of time to ease sore nipples. They often lead to future issues with poor attachment so need to be used with advice and careful consideration.
Some causes of sore nipples need medical intervention. Thrush can be treated with an ointment that is safe for baby, mastitis may need antibiotics so it does not become serious and lead to hospitalisation. Always seek out advice from a medical professional.

Where do I find help?

You can contact the following organisations for more information:

Lactation Consultants of Australia and New Zealand (LCANZ)

Australian Breastfeeding Association runs the National Breastfeeding Helpline 1800 686 268

Maternal and Child Health Line (24 hours) – 13 22 29

Nurtured Birth postnatal doula available for home visits in Melbourne, even during Covid-19 times.

Written by Sharon Clarke, Remedial Therapist at Nurtured Birth

Successful breastfeeding is expected by most new mamas, because it’s … well, natural.

The truth is, since the beginning of time, new mamas naturally fed their babies after watching and learning from other women around them. It’s only been in our recent history that breastfeeding has come less naturally to new mothers.

Changes in social attitudes meant birth and breastfeeding became less visible. Our grandmothers, mothers and our own generation missed out on that vital firsthand experience of watching others go through these life-changing events.

It’s actually not surprising that today while most new mamas do breastfeed their newborns after birth, very few continue to exclusively breastfeed until 6 months.

We know how important breastfeeding is for babies and mothers, and getting it right from the start is key to a successful breastfeeding relationship.

If you are a mama-to-be who wants to prepare for breastfeeding, here are some valuable tips to ensure your journey is successful:

#1: Learn about successful breastfeeding before birth

Research indicates quality education about postnatal parenting and breastfeeding is the best step to ensure a successful breastfeeding experience.

Learning about breastfeeding before you give birth means you have the time and energy to actually take on the information. Trying to learn about breastfeeding when you and baby are recovering from birth can be overwhelming.

You’re also more likely to implement some of the other tips covered in this blog post. How you decide to learn about breastfeeding can be through attending a class, such as those the Australian Breastfeeding Association runs, antenatal classes at your hospital, or with a private lactation consultant (see tip #6 for more information).

#2: Understand normal newborn behaviour

I don’t think there’s a parent alive who hasn’t been in the presence of their newborn for the first 24 hours and thought ‘wow, we hit the jackpot with a quiet sleeping baby’. The first 24 hours or so after birth, a newborn tends to sleep a lot, feed a little, and maybe cry some too.

Then 1-3 days after birth, your baby is more awake and aware. They also realise food isn’t on tap anymore, are quite hungry and cry a lot more. They tend to want to feed very frequently.

This is actually very normal newborn behaviour. They have small tummies and need to feed often, especially as they’re helping to increase their food source – your milk supply.

Most new mamas aren’t prepared for this change in their baby. They feel they’re doing something wrong, their baby isn’t getting enough milk and that’s the reason for the crying and fussiness.

This stage doesn’t last, but it can be very frustrating and exhausting when it does. Being aware that this is very likely to happen, and being patient with yourself and your baby is a step toward getting through this stage.

#3: Who’s got your back?

In the months and weeks before giving birth, have a look around your immediate support network. Who do you know breastfed for at least 6 months, even beyond? Ask that mama questions about what she felt helped her the most.

It’s a good idea to discuss your intentions to successfully breastfeed with your partner, family and close friends. Research shows partner support is one of the biggest factors in new mamas continuing to breastfeed. If you feel your partner might be less supportive or concerned, get along to a breastfeeding class together. Talk to your partner about how important it is to have their support.

Think carefully about the people in your life who are less likely to be supportive. Many women find the older generation has a very negative attitude towards breastfeeding. It can be wise to be aware of this and have a frank discussion beforehand about your intention to breastfeed and expectation they will refrain from being negative about it.

#4: Create a successful breastfeeding plan

It’s likely you’re already preparing your birth bliss plan, the document that lists your intentions and preferences when you go into labour. Include your breastfeeding bliss plan on your birth plan too. This should state your preferences for the first hour after birth (see tip #5).

In the first hour after birth, your baby will likely be quiet and alert, which is the perfect state for the first breastfeed. Stay skin-to-skin with your baby and allow your baby to seek your nipple.

This can take a little time but all babies have an innate instinct to find their mother’s nipple very soon after birth. Ask care providers to refrain from touching or forcing your baby to take the nipple until they’re ready.

It should be said, most maternity hospitals support early breastfeeding when labour and birth has been uncomplicated. It’s usually when you or baby have needed medical intervention that breastfeeding can be interrupted.

Where appropriate, have skin-to-skin with your baby (or with your partner). Where possible, seek support to feed your baby directly from your breast. It can be useful to have on your birth preferences that your baby is not to be given any artificial nipples or formula unless medically indicated and with your consent.

Babies in special care nurseries can be given breast milk by oral syringe or feeding tube, so ensure all care providers are aware of your preferences. Speak to the hospital lactation consultant (or your own) about pumps and how to best keep up your supply if you’re separated from your baby for some time.

#5: Plan for a normal birth

Women have been giving birth since the beginning of humanity with minimal intervention. It’s only been in the last few centuries we’re started to interfere with the process. Mostly this has been with good intention, to prevent anything risky from happening.

Unfortunately, intervention during labour has consequences and often the time after birth is affected but least considered. During your baby’s first hour, if they are given skin-to-skin contact with you, this helps them to regulate their temperature and respiration, boosts their immunity, helps with the third stage, and improves successful breastfeeding rates.

Babies born to mamas who haven’t had pain medication are also more likely to breastfeed than those mamas who have. That being said, if you do need medical intervention or choose to have pain medication, you don’t have to miss your baby’s first hour.

See tip #4 above for suggestions on how to make that work for you and your unique situation.

#6: Call the breastfeeding expert

It might seem pre-emptive to hire a lactation consultant when you’re pregnant and not yet breastfeeding. But when it’s day three after birth and you’re in tatters because your baby is crying and won’t latch and it seems impossible to go on, you will be glad to have your LC on speed dial.

A lactation consultant is a breastfeeding specialist. They have special training and can help identify what’s not working and how to resolve it. Most early breastfeeding challenges can be fixed, with the right, qualified support.

If hiring a private LC isn’t possible, ask your midwife what support is offered by your hospital or through your local council. Keep the Australian Breastfeeding Association helpline number handy for help too.

At Nurtured Birth we are here to support you in your journey to breastfeed after birth and beyond. Find out more about us and our services here.

Author: Sam McCulloch, Wordsmith at Nurtured Birth

Tag: lactation

Sore Nipples and Breastfeeding: What You Need To Know