Hesperian Health Guides
Problems with breastfeeding
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Pain in the breast can be caused by a sore nipple or breasts that get very full and hard. The pain will often go away in a day or two. It is important to keep breastfeeding the baby even it if hurts, and to let the baby suckle often. It also helps to change the baby's position each time she nurses.
Sore or cracked nipples
Sore or cracked nipples can develop when the baby sucks only the nipple instead of taking the nipple and part of the breast into her mouth when she is breastfeeding.
Prevention and treatment:
- Let the baby feed as long and as often as she wants.
- When the baby has stopped feeding, squeeze out a few drops of milk and rub them on your nipples.
- Do not use soap or cream on your breasts, unless you have an infection. Your body makes a natural oil that keeps the nipples clean and soft.
- Avoid tight or rough clothing.
- If the pain is too great when the baby suckles, remove your milk by hand and feed the baby with a cup and spoon. A crack in your nipple should heal in 2 days.
- Do not let your breasts get hard and overfull. If you have more milk than the baby can drink, cover your breasts with warm cloths or towels and empty your breasts by hand after the baby is full. After a few weeks you body will usually make just the right amount of milk, and your breasts will not get too full.
If a baby is in a good position while suckling and you still have pain in the nipples that lasts for more than a week, it may be caused by thrush (a
yeast infection on the nipple or in the baby’s mouth). Your nipples may itch or you may feel a stabbing, burning pain. The baby may have white spots or redness in her mouth. She will be fussy if her mouth hurts.
Thrush can lead to sore and cracked nipples and breast infection. Both mother and baby should be treated.
Breast infection (mastitis)
Painful breasts and sore or cracked nipples can lead to an infection inside the breast.
- Part of the breast becomes hot, red, swollen, and very painful.
- Fever or chills.
- Lymph nodes in the armpit are often sore and swollen.
- Abscess (painful lump in the breast) that sometimes bursts and drains pus.
Keep breastfeeding frequently, giving the baby the infected breast first, or milk the infected breast by hand, whichever is less painful. The infection will not pass to the baby.
- Rest and drink lots of liquids.
- Use hot compresses on the sore breast for 15 minutes before each feeding. To reduce pain, use cold compresses on the sore breast between feedings.
- Gently massage the sore breast while the baby is nursing.
- Take paracetamol for pain.
- Use an antibiotic. Dicloxacillin is the best antibiotic to use. Take 500 mg by mouth, 4 times each day, for 7 to 10 days. If you cannot find this or are allergic to penicillin, use erythromycin. Take 500 mg by mouth, 4 times a day for 7 days.