One of the things moms who plan to nurse worry about the most is that it will hurt. While some soreness and tenderness is normal, there are a lot of things you can do to prevent and ease nipple pain.

Causes of Nipple Soreness

If your nipples are very sore, blistered, cracked, or bleeding, the first thing to do is make sure your baby is latching on correctly. He should be taking not just your nipple, but as much of the areola as possible, into his mouth. When he sucks, there shouldn't be any clicking sounds or dimpling in his cheeks. If he is only sucking on your nipple, not only will your nipples become very sore, but also his sucks won't stimulate your breasts to produce milk effectively. Follow the steps for good latch detailed earlier in Chapter 3. If at any time something feels or looks wrong, break the latch and try again. Some women find that expressing a little breastmilk after each feeding and rubbing it into the nipple and areola is a soothing and healing treatment. Just make sure to pat your nipple dry afterward.

Additionally, when your baby nurses in one position every time, it can create a lot of pressure on one area of your nipple or areola and can make it harder for sore, cracked nipples to heal. Try switching your baby's position each time you nurse.

Certain conditions in your baby, like nipple confusion caused by receiving bottles or pacifiers while nursing is being established, or a short frenulum (the tissue that attaches the tongue to the bottom of the mouth), also called tongue-tie, can make achieving a proper latch difficult and can exacerbate sore nipples. If you're having a hard time getting your baby to latch on or suck effectively, consult your lactation consultant, a La Leche League volunteer, or your midwife or doctor for help.

Soothe with Salve

Pure lanolin is a tried-and-true remedy for sore nipples. Its sticky, thick consistency makes it a great choice for moist wound healing: instead of allowing sores and cracks to dry and develop scabs, which are then ripped off again and again when you nurse, moist wound healing can be a more comfortable and effective way to mend nipple sores, cracks, and blisters.

Pure, medical-grade lanolin is readily available at drugstores and even at some grocery stores, most readily under the brand names Purelan and Lansinoh. You don't have to remove lanolin from your skin before your baby nurses. Rarely, wool allergies are linked to reactions from purified lanolin, so if you have an allergy to wool, you might want to test the lanolin on a small area of your skin first.

Other Remedies

Many women swear by a product called Soothies, which are cooling gel pads you apply to your breasts between feedings. The coolness can feel wonderful, and Soothies create a protective, moisturizing shield between your nipple and bra or shirt. Another option is a breast shell (not to be confused with a breast shield, which can cause supply issues and should only be used under the recommendation of an experienced lactation consultant, or your midwife or doctor). Breast shells are worn between feedings and help keep your nipple from sticking to your bra or shirt, which can be painful and reopen sores. They are also sometimes used to draw out inverted nipples.

Keep Nursing

When your nipples hurt, it can be hard to even think about nursing without cringing. But as hard as it can be, putting off feedings out of fear often makes matters worse; if your breasts become engorged, nursing will hurt even worse and you may develop an infection. Nursing more often, not less often, is the best plan of attack for sore nipples.

Try nursing on the least-sore side first. Once milk gets flowing, your baby may not suck as hard on the sore side. If your breasts are very engorged and it's making it difficult for your baby to nurse, try pumping or hand expressing a little milk to soften the nipple and ease latch-on. If you're really desperate, try pumping at every other feeding, or pumping at the beginning of a feeding, to soften the nipple and make it easier for your baby to latch on.