How to Prevent Nipple Cracks During Lactation

If you have sore breasts after breastfeeding, chances are you suffer from cracked nipples. We tell you how to prevent this problem.

Reviewed and approved by the doctor Diego Pereira.

Written by Ana Luzardo

Last update: 02 July, 2023

The breastfeeding period is one of the most special for both mother and baby. However, it’s common for women to experience unpleasant symptoms due to the sensitivity of their breasts. How can nipple cracks be prevented?

Whether due to poor latch-on of the baby to the breast, improper use of the breast pump, or infection, the breasts – and especially the nipples – can develop cracks, pain and even bleeding. Fortunately, it isn’t usually serious and can be prevented with some care. In the following article, we’ll give you the low down on what you can do.

Tips to prevent nipple cracks during breastfeeding

When breastfeeding begins, it’s normal to experience nipple tenderness or mild discomfort. However, this is usually temporary and disappears as you breastfeed your baby. After that, it’s normal for this process to be comfortable and painless. If this isn’t the case, then it’s necessary to evaluate whether there’s a problem.

Information shared by the Journal of Pharmacopuncture estimates that 80-90% of breastfeeding women experience sore and cracked nipples.

As detailed in a publication in the International Journal of Environmental Research and Public Health, nipple soreness is an indication of poor positioning and latch-on during breastfeeding. It can also be caused by infections, abnormalities in the baby’s palate, mastitis, vasospasm, or inverted nipples.

The good news is that there are several strategies to help prevent this condition and its possible associated complications. All it takes is a few adjustments in the way you breastfeed as well as some routine care. Let’s take a look in detail.

1. The baby’s latch during feedings

The first measure to prevent nipple cracks is to check how the baby latches on to the breast. When the baby’s latch-on is incorrect, pain and cracking are common. There are ways to find out if this is the problem. According to experts, the signs of a correct latch-on are the following:

• Their mouth is wide open
• They cover a large part of the areola
• Everted lips (outward facing)
• Chin close to the mother’s breast
• The baby’s head and body aligned

2. Correct disengagement

If, for whatever reason, you need to disengage the baby, instead of pulling on him and causing pain, insert a clean finger between the breast and his gums. Then guide his head away from the breast. Via Beaumont Health warns that it isn’t correct to pull the baby away from the breast, as this can hurt them.

3. Adjust your position

You should also ensure that you’re comfortable when you breastfeed. There are different breastfeeding positions; you can change positions, try props such as breastfeeding pillows, and hold your baby close to your breast instead of bending over them. Keep in mind that their face and hips should be turned toward you while breastfeeding.

4. Moisturize your nipples

Nipples should be moisturized during breastfeeding because when they’re dry they’re sensitive and can crack and bleed. You can use nipple creams, as long as they are suitable for babies, because their mouth will be in contact with the area.

The Cleveland Clinic suggests creams with lanolin, purslane cream, diluted peppermint oil, or menthol essence. To use them, clean the area well with water and apply the cream when you finish feeding your baby. This will allow the skin to absorb it after the next feeding.

5. Prevent or decrease engorgement

Engorgement refers to excessive filling of the breasts with milk. When this occurs, a woman usually experiences swelling, soreness, and cracking of the nipples. It often happens after a long time without breastfeeding.

To prevent it, you can express milk with a breast pump. However, if it has already occurred, it’s advisable to practice the following:

• Pass a warm wet towel compress on one breast at a time.
• Massage the breasts while in the shower and let the milk drip out.

6. Use the ideal breast pump funnel size

You need to measure the nipple face with a tape. It should be done in millimeters and two extra millimeters should be added. Using the measurements, you can choose the most appropriate one.

To find out if you have the wrong funnel (also called flanges), you should make sure that the nipples don’t rub against the sides of the breast shield tunnel, that not too much areola enters the breast shield tunnel, and that there are no areas of the skin with marks or redness. The nipple shouldn’t be white in color, you shouldn’t feel pain, and no lump should appear on the breast after the extraction.

7. Keep your breasts dry

If you’re one of those mothers who leak milk, remember to change your nursing pads frequently and also your bras. Keeping the area dry is crucial to avoid infections, cracks, and bad odor.

8. Treat baby’s frenulum

If your baby has a sublingual frenulum, it can cause pain and cracking. This is a congenital malformation under the baby’s tongue. The tongue is tied to the floor of the mouth and breastfeeding movements are limited or impeded.

To find out if your baby has a sublingual frenulum, it should be assessed by a pediatrician.

9. Use hydrogel pads

Hydrogel pads have become popular as an ally in preventing nipple cracks during breastfeeding.

A study shared through the Journal of Obstetric, Gynecologic & Neonatal Nursing found that their application resulted in greater pain relief and a lower rate of nipple injury. In fact, their effects were superior when compared to a lanolin ointment.

These pads are available at pharmacies and specialty maternity stores. They’re applied directly to the breast to soothe and cool. Some have moisturizing components and can be reused for up to 24 hours.

When to seek medical help?

If the breastfeeding process is uncomfortable and recurrent, it’s important to seek help as soon as possible. Breastfeeding counselors and pediatricians can help solve the problem to make this task more comfortable and enjoyable.

This should be done as soon as possible, as the associated problems don’t take long to appear. The mother may experience mastitis, among other infections, while the baby may have difficulty feeding properly.