Sore nipples: separating fact from fiction

If you ask your mother what the words “nipple preparation” bring to mind, she will probably recall some detailed and uncomfortable practices she was advised to do during the final weeks of pregnancy. Depending on when you and your siblings were born, they might include some gentle massage with wool fat (lanolin) and exposure to sunlight - or if she was unlucky, rubbing with nail brushes and methylated spirits!!

All this preparation was in the hopes of preventing sore nipples in the early days of breastfeeding. It didn't. I think the theory of toughening up nipples came from observation of cultures where women went about bare breasted and also seemed to not have trouble breastfeeding.

Of course, the reason these women appeared to have less problems breastfeeding was that they were nurtured by experienced mothers in the early days and had grown up seeing how babies went on the breast.

It was when breastfeeding advocates looked more closely that the connection between nipple pain and poor attachment was realised. Until the 1990s, babies were held to the breast in positions which only allowed them to take the nipple into their mouths. Because of this, delicate nipple skin was being compressed by the baby's tongue throughout feeds. It was this that caused pain.

Your mother was probably told to limit time at the breast, apply lanolin and to air her breasts after feeding. She might have even used a heat lamp or hair dryer on them. Creams, ointments and other topical treatments were applied.

Some women were told they were at risk of sore nipples because they had pale skin and red hair! Others were told their baby’s mouth was too small.

While it is typical for the nipples to seem extra sensitive in the first few days and nobody gets attachment right every feed from the start, damage to nipples is an indicator that your baby isn’t taking a good mouthful of breast tissue and the nipple is in the wrong place. By improving positioning and attachment, the cause is removed and the skin quickly heals.

The most effective thing to put on sore nipples is a well-attached baby.

If cracks or grazes develop, it is important to be aware that infection from thrush or bacteria might follow. A little expressed breastmilk smeared on the skin and allowed to dry after a feed is a safe and effective aid to healing. Do check with a doctor or nurse if it gets too painful to feed or doesn't seem to be healing.