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Nipple Care: How to Deal with Common Breast Infections for Nursing Moms

Mom Health / Jul 06, 2022 / Vetted by Dr Sandip Gupta, MBBS, MD, FNB-PICU
Nipple Care and other infections

A newborn baby breastfeeds almost every two hours, which can make the nipples very sensitive during the initial few days of breastfeeding. You may experience tenderness and soreness of the nipples as you get used to the strong sucking of your baby. If your baby is not latching onto the breast correctly, you may develop pain and infection of the nipples. As a result, nipple care during breastfeeding becomes essential for new mothers. Prior to that, let's discuss some common nipple conditions that are likely to occur during breastfeeding.

Sore nipples

The initial soreness just after breastfeeding starts goes away with time. However, sometimes, when the baby is unable to get milk properly and sucks too hard, you may experience cracked, bruised or bleeding nipples. This happens when:
  • The baby is not positioned properly.
  • The baby has problems with latching 
  • The baby keeps sucking for comfort
  • The baby's mouth is pulled away from the breast without breaking the suction
  • The baby has a tongue-tied situation
  • You have flat or inverted nipples

You can continue breastfeeding even if you have bleeding or cracked nipples. The goal here is to encourage your baby to feed properly so that your nipples can heal. 

How do I take breast and nipple care while breastfeeding?

Most times, helping your baby achieve good latch and positioning can reduce the soreness and pain. Here are some general tips on nipple care during feeding :
  • Air dry nipples each time after feeding.
  • Use a cold compress on your nipples after each feeding to ease the discomfort.
  • Place breast shields between the nipples and your clothing to avoid contact.
  • Use adequate breast support. Too tight bras will irritate your nipples.
  • Apply a little breastmilk to your nipples. Breastmilk contains antibodies and skin softeners that will help to keep your nipple healthy.
  • You can also take a small amount of lanolin and apply it to your nipples and areola. This forms a barrier and provides soft, supple skin, and helps in healing.
  • Start breastfeeding on the side that is less sore and, after a few minutes, you should switch the breast. This way, the sore nipple will be protected from the intense sucking that happens in the first few minutes.

Call your doctor immediately if you have increasing pain in your breast, redness in an area of the breast, pus drainage from the nipple, fever, or a hard lump in your breast.

Symptoms of Mastitis

Mastitis is the breast inflammation that occurs in the initial 6 to 12 weeks of breastfeeding. It is caused by germs that enter your breast from the baby’s mouth or the skin via milk duct or cracked nipple. The likelihood of developing mastitis is when you have cracked or sore nipples, wear a tight-fitting bra or use only one position to breastfeed. Nipple discharge, breast pain, fatigue, headache, fever, nausea and vomiting are some symptoms of mastitis. For better nipple care and to treat mastitis, you can:
  • Massage the breast in a circular motion
  • Apply warm compress
  • Breastfeed on the affected side frequently so that milk keeps flowing
  • Wear a good supportive bra
  • Take medicines like ibuprofen and acetaminophen to reduce pain.

Mastitis can be identified by your doctor who will check for swelling, tenderness and a painful, wedge-shaped area on your breasts. The doctor may recommend a few tests including breast ultrasound, MRI, mammogram, or biopsy. Contact your doctor if you have blood or pus in your milk, a painful lump, red streaks, or an infection in both breasts.

Symptoms of Nipple Thrush

Candida albicans causes nipple thrush, a fungal infection. Thrush causes mild to severe pain, as well as burning, stinging, and itching. Following are the symptoms of nipple thrush :
  • Your nipples may be bright pink and cracked
  • The areola may be dry, flaky, or reddened
  • Your baby's mouth may have a white coating on the tongue or white spots on the cheeks[6]
  • You feel severe pain in the breast during and after breastfeeding 
  • It is important to treat thrush because it can spread quickly, especially in warm areas like the baby's mouth. For the treatment of fungal nipple thrush:
  • You need to apply antifungal nipple cream
  • Keep your nipples dry
  • Wash your clothes in soapy water and dry separately
  • Use oral drops or gel if your baby's mouth has signs of thrush.
  • Pump your milk and feed your baby using a clean cup and spoon if you have cracked nipples 
  • Clean your hands properly with soap after applying any creams or ointments and after nappy changes to prevent the spread of thrush.

Nipple thrush and sore breasts can be identified with just a physical examination. You should examine your nipples regularly for any signs of infection. It is important to take good nipple care to resolve an infection before it spreads to prevent pain for you and your baby. Wash your nipple periodically to avoid any bacterial infection. Also, use a right-fitting bra to support your breasts. Remember, while your areola may feel tender initially, nursing in itself shouldn't be painful. 


References:

  1. C.S. Mott Children’s Hospital. Breastfeeding: sore nipples [2020]
  2. La leche league international. Breastfeeding with sore nipples [2020].
  3. Pregnancy birth & baby. Sore, cracked or bleeding nipples  [2020].
  4. Cleveland Clinic. Mastitis [2020].
  5. Familydoctor.org. Mastitis [2020].
  6. The Women’s. Breast & nipple thrush [2020].
  7. La leche league international. Is thrush causing my sore nipples? [ [2020].

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