Sore Nipples While Breastfeeding: Causes and Relief

Sore nipples are one of the most common reasons people find breastfeeding hard in the early weeks. The CDC notes that nipples can feel tender or sensitive at first while they adjust. But breastfeeding shouldn’t keep hurting once your baby is latched well, and cracked or bleeding nipples are a signal to get help, not something to push through.

The good news is that most nipple pain has a cause you can find and fix. Here’s how to work out what’s going on and what helps you heal.

Normal tenderness or a problem?

Usually normal	Worth getting help
Tenderness for the first few seconds of a latch, easing as the feed goes on	Pain that lasts through the whole feed
Mild sensitivity in the first days	Pain that gets worse instead of better after the first days
Nipple looks round after a feed	Nipple looks pinched, flattened, wedge-shaped or white after a feed
	Cracks, blisters, scabs or bleeding
	Pain between feeds, burning or shooting pain

Common causes of sore nipples

A shallow latch or awkward position

The NHS calls a poor latch the most common cause of nipple pain. When your baby takes only the nipple instead of a big mouthful of breast, the nipple gets squeezed against the hard palate. Signs include pain throughout the feed and a nipple that looks flattened or creased afterward.

Try bringing your baby to the breast chin first, with the nose level with your nipple and a wide-open mouth. Laid-back, football and cross-cradle holds can all help. Our guide on how to breastfeed walks through latch and positions step by step.

Taking baby off the breast

Pulling your baby away while they’re still sucking can hurt. Break the suction first by slipping a clean finger into the corner of your baby’s mouth.

Tongue tie

A tight band of tissue under the tongue can stop your baby from extending the tongue to latch deeply. La Leche League lists clicking, slipping off the breast, very long or constant feeds, slow weight gain and nipple pain or damage as possible signs. A lactation consultant or your pediatrician can assess your baby’s mouth and discuss whether a procedure (frenotomy) might help.

Engorgement

When your breasts are very full, the areola can become tight and flat, making it hard for your baby to latch. Softening the area first helps; see our guide to breast engorgement.

Thrush

Thrush is a yeast infection that can affect your baby’s mouth and, according to the NHS, your nipples. The NHS lists burning nipple pain especially after every feed, itchy nipples and flaky or shiny skin as signs, but adds that nipple pain may not be thrush at all and could be a latch problem. Some experts, including the ABM and La Leche League GB, doubt that yeast is a common cause of nipple and breast pain, so see our thrush guide for what the evidence says. Your doctor can check both you and your baby, and you can keep breastfeeding if thrush is confirmed.

Vasospasm

Some people have spasms of the blood vessels in the nipple, similar to Raynaud’s phenomenon. The nipple turns white, sometimes then blue or red, with burning or throbbing pain after feeds or in the cold. It is often linked to nipple damage from a shallow latch. Keeping the nipples warm after feeds, for example by covering them right away, can help. If it continues, talk to your doctor; ABM Protocol #26 on persistent breastfeeding pain covers medical treatment options.

Pump problems

A flange (breast shield) that’s too small can rub the nipple; one that’s too large pulls in too much areola. Suction that’s set too high can hurt and damage skin. Use the most comfortable setting that still lets milk flow, and check that your nipple moves freely in the tunnel. Our flange size calculator helps you find a better fit, and our pumping guides cover the rest of pump setup.

Other skin causes

Soap, detergents, tight bras and some creams can irritate the skin. Eczema and bacterial infection are possible too, especially if cracks aren’t healing.

Caring for cracked nipples

• Fix the latch first. The NHS notes that self-help tips won’t be effective if your baby is poorly attached.
• Start on the less sore side, then switch once milk is flowing.
• Keep feeding. The NHS advises against shortening feeds because of soreness; it is unlikely to help and may reduce your milk supply.
• Rinse with plain water rather than soap, and let your nipples air-dry after feeds.
• Change breast pads often so the skin doesn’t stay damp.
• Wear a soft, well-fitting bra.
• Use pain relief if needed. Our guide to ibuprofen and Tylenol while breastfeeding covers the LactMed evidence for both. Use the standard adult dose on the label and check with your doctor or pharmacist about your situation.

If a crack is very painful and you need a break from that side, hand expressing or pumping gently can keep your milk flowing while it heals. Ask a lactation consultant before taking a long break.

What helps: the evidence

Option	What the evidence says
Expressed breast milk	A few drops rubbed gently on the nipple after feeds is free and low risk. The NHS and La Leche League both suggest it. The Cochrane review found it may be equally or more helpful than an ointment such as lanolin for short-term pain. La Leche League says not to use it when soreness is due to thrush.
Lanolin	Widely used. La Leche League suggests highly purified lanolin, and LactMed says it should be avoided if you have a known wool allergy. The Cochrane review found no clear difference in nipple pain between lanolin and nothing, and expressed breast milk may be equally or more helpful in the short term. La Leche League says lanolin is not recommended if you have a yeast infection.
Hydrogel (gel) pads	La Leche League says gel pads may relieve soreness and promote healing, but the Cochrane review found no evidence that glycerine gel dressings significantly improved nipple pain. La Leche League does not recommend them if you have a yeast infection. Follow the package directions.
Nipple shields and breast shells	Not a first-line fix. The NHS suggests avoiding them where possible; a lactation consultant may use them in specific situations.
Time	The Cochrane review found that for most women, nipple pain fell to mild levels about 7–10 days after birth regardless of treatment.

When to get help

Contact a lactation consultant, your midwife or your doctor if:

• Every feed hurts, or your nipples crack or bleed
• Pain hasn’t improved after the first 1–2 weeks (CDC)
• Your nipple looks pinched or white after feeds
• You have burning or shooting pain, especially if it started after weeks of comfortable feeding
• A crack looks infected: yellow crust, pus, spreading redness or increasing pain
• You have a fever, chills or a red, painful area of the breast, which could be mastitis
• Your baby isn’t gaining weight well or has fewer wet diapers than expected

Our breastfeeding support page lists where to find a lactation consultant and free helplines. For other common challenges, visit our breastfeeding problems hub.