Common Breastfeeding Questions and Problems - Article Two

Starting Out (continued)

Sore Nipples

What if my nipples are getting sore? If nipple soreness occurs, scrutinize your technique of positioning and latch-on to be sure that you are not letting the baby apply pressure directly on the nipple rather than on the areola. Pay particular attention to how the baby is opening her mouth. Be sure it is wide enough and everting both lips, especially the lower. It is often hard for the mother to see if baby's lower lip is everted. It might be necessary to ask an experienced breastfeeding mother to observe your latch-on. Try to position the nipple far back in baby's mouth. You will need to get the baby's mouth open wide to do that and you may have to help baby open her mouth wider by using the index finger of the hand supporting your breast to press firmly down on baby's chin as you pull her on. If you get a pinching feeling, temporarily remove the hand supporting your breast and use your index finger to evert (turn out) her lips. If baby does not cooperate you may need to start over. Break the suction by gently wedging your finger between the gums. Then try again until baby is doing it properly. If you immediately sense less nipple soreness, then a tight latch-on is the problem. Also, change the way baby is angled and put baby to the least-sore breast first.

Nipple care. When not "in use," be sure the surface of the nipple is free of wetness. Use fresh breast pads, without plastic liners, be sure no moisture is in contact with your tender skin. Gently blot the wetness off with a soft cloth before putting your bra flap up. In the past it used to be suggested that quick drying, exposing to sun, etc. but that could lead to nipple tissue cracking which disturbs the moisture balance needed for skin softness and elasticity.
Transitional tenderness. Some women experience a transitional period of tenderness as the skin of the nipple acclimatizes itself to the sucking. Should you experience this tenderness, check your latch-on techniques. Also, massage the nipples after feeding to promote circulation to the tissues. The best massage medium is colostrum or breast milk. Additionally, the little bumps on the areola around your nipples are glands that secrete a cleansing and lubricating oil to protect the nipples and keep them clean. Therefore, avoid using soap on your nipples, since it removes these natural oils and encourages dryness and cracking.

First aid for nipples. Women with a predisposition to dry skin can develop dry, cracked nipples even when practicing correct positioning and latch-on. Do not use oils or creams that need to be washed off before breastfeeding, even if the hospital offers you one. Try Lansinoh, a pure, hypoallergenic, pesticide-free lanolin, if cracking and fissuring develop and breast milk alone as a massage medium is not helping. Lansinoh promotes healing by encouraging normal tissue moisture, and it does not have to be washed off before breastfeeding.

If the nipples become more sore, cracked, or fissured in spite of these remedies, you need hands-on help from a lactation consultant. They will work with your technique and/or baby's suck and will help manage the feeding of baby until the problem is solved.

My baby feeds constantly, my nipples are wearing out, and I'm wearing out. Can I give a pacifier? Many babies love to suck for comfort, not only for nourishment; and there is no better pacifier than a mother suckling an upset baby peacefully off to sleep. Realistically, however, the human pacifier may need a rest. It is discouraged to use an artificial pacifier in the early weeks while baby is learning correct sucking patterns at the breast. After the sucking patterns mature and nipple confusion is no longer a concern, a pacifier may be a real lifesaver for a tired mother, and a soothing comforter for an insatiable sucker.

There will be more articles to come on Common Breastfeeding Questions and Problems.