Causes of Sore & Cracked Nipples During Breastfeeding

There are several possible causes of sore nipples in a breastfeeding mother. It is important to identify the cause of pain early on and resolve the issue as soon as possible so as to prevent further complications. Nipple cracks and fissures can allow bacteria to enter the breast, often resulting in mastitis, thrush and breast abscesses, the presence of which can further delay healing. Here is a list of the likely causes of sore nipples as a result of breastfeeding:


Nipple pain is often caused when a baby is not latched (attached) to the breast properly - so the baby is 'nipple feeding' instead of breastfeeding. A poor latch can cause painful feeds, blisters, cracks, grazing or bleeding to the mother’s nipples. Once the latch has been improved, sore or cracked nipples can heal relatively quickly with correct treatment. Click here for information on healing sore and cracked nipples.

Sometimes however, the situation is not as simple as just fixing the latch.  Positioning and attachment may be correct, but a mother may still have severe burning, throbbing or shooting pain in the nipples during feeding. Doctors and Medical Professionals often associate sore nipples during breastfeeding with incorrect attachment and correcting the latch is the common recommendation for treatment of nipple pain. However, other studies have shown that one, or even several instruction sessions on proper positioning and attachment during the first few days after birth did not result in longer breastfeeding or fewer breastfeeding problems. This highlights the fact that faulty positioning and attachment are not the only cause of nipple pain and therefore nipples should be assessed and the treatment should be determined on an individual basis.   


Recent studies have revealed excessive nipple movement inside the baby’s mouth and strong suction as the cause of nipple pain in some mothers –“Infants of breastfeeding mothers experiencing persistent nipple pain applied significantly higher vacuum to the breast during breastfeeding despite assistance with positioning and attachment from a lactation consultant”. The same study found that two thirds of mothers with chronic nipple pain had babies that exerted significantly stronger vacuums compared to infants of breastfeeding mothers without pain. These factors are often not considered by doctors and lactation consultants and should be taken into account when treating painful nipples. When there is frictional pain, highly purified lanolin and hydrogel dressings can be used to alleviate the pain and accelerate healing. Click Here for information on healing sore and cracked nipples.


Flat or inverted nipples may act as barriers for the baby to latch on to the breast effectively. Various methods to correct flat and inverted nipples with varying degrees of success and complications have been reported in the literature. These techniques include prenatal exercises like Hoffman’s exercise, nipple stimulation techniques, postnatal use of the Niplette, using breast shells to make the nipple prominent, use of a breast pump to draw out the nipple before breastfeeding, and use of nipple shields. In addition to the use of these techniques, mothers with inverted or flat nipples should seek professional assistance with positioning and latch-on. 


Although many babies with Infant tongue-tie (ankyloglossia) are able to breastfeed effectively without causing nipple pain, it is now recognised that some of these babies have difficulty maintaining latch to the breast and do cause nipple pain. In these cases, tongue-tie surgery (frenotomy) can be effective in reducing pain and improving milk transfer and often provided successful resolution of nipple pain.


Moms who have moderate to severe nipple pain that lasts more than a few days, even after the baby’s latch is corrected could be a sign of an infection, including Candida albicans (Thrush), Staphylococcus aureus and Herpes simplex virus. These infections will contribute to prolonged pain and need to be examined by a Doctor to advise the correct treatment. Nipple pain due to infection can be treated with antibiotics for confirmed bacterial infection, or an antifungal for Candida infection. 


A milk blister or milk bleb is a white spot on the nipple or a blocked nipple pore or duct. Clinical advice for milk blisters involves the application of a warm compress followed by breastfeeding or lancing the blister with a sterile needle.


Have you suffered or are currently suffering with any of the issues mentioned above?  I would love to hear from you, please leave me a comment below.

Our Nipple Crème is 100% ultrapure medical grade lanolin that will help ease the discomfort of cracked and sore nipples associated with breastfeeding. It is the ideal treatment for Stages 1 and 2 of nipple damage and is also excellent for early protection of sensitive and dry nipples during pregnancy.

Thanks for reading. If you have any questions or queries please feel free to leave a comment below. For more tips and advice on maternity skin care check out the Expert Advice section of the Natralogic website.

All the best

Lauren Lamont - Natralogic Founder

MSc Chemistry, Dip.Cos.Sci (SA)


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