Nipple care: preventing & treating nipple damage

While breastfeeding is natural and wonderful, it's not without challenges. For many mums, learning how to breastfeed properly can be a bit of a mission, and you can end up causing short term and fixable damage to your nipples. The latching-on process and mastering the art of it all does take time, but it's so worth it to hang in there! The upsides of breastfeeding are that longterm, it helps with bonding, it's convenient - and it's free!

Preventing sore nipples

Keeping your breasts clean is important if you're breastfeeding. It's best to wash nipples with water only because  soaps remove the natural protective oils. Breast milk and baby's saliva have healing properties which help with cracked and sore nipples (see below). After feeding or washing, gently rub a drop of breastmilk on to the nipples and let it dry in the air.

Possible causes of sore nipples

Checking that your baby's latch, and your and your baby's positions are correct will go a long way to helping avoid sore nipples. Read our top tips and advice in our guide to breastfeeding.
•Remember  you need to wait for baby's mouth to open wide and see that the tongue is down before baby takes the breast.
•Break the suction with your little finger before taking baby off the breast.
•Check the shape of the nipple after baby comes off. It should be round, not squashed or flattened.
•Have your doctor/midwife/Plunket nurse check the baby for thrush (white spots in mouth and white tongue long after having fed).

If your nipples are cracked and sore, try to continue breastfeeding if you can. Some mothers continue to feed even though the nipple bleeds during a feed, simply to keep up their milk supply. Another option during this time is to express milk and bottle feed this milk to baby. If it's too sore to continue breastfeeding, discuss your options with your LMC. You may need to give baby a few formula feeds just until your nipples have healed enough to continue on. Just remember your longterm goal in doing this is to be able to breastfeed your baby for as long as you plan to. Having this brief time out from breastfeeding is better than being completely put off it.

Caring for your nipples after the damage has been done

Don't be discouraged if breastfeeding hasn't panned out as you thought it would. There is light at the end of the tunnel, and if you can bear with it for a week or two (hopefully just days) the discomfort will go away and you will experience the wonderful world of breastfeeding!

The best way to care for dry cracked and possibly bleeding nipples is to keep them moisturised. The product that comes highly recommended by midwives, mums and OHbaby! is Purelan by Medela, available from any pharmacy. Put a generous amount of Purelan on your nipple, then cut some small squares of Gladwrap (yes Gladwrap!) and put them over your nipple and put your bra back on. The Gladwrap works with your natural body warmth to increase the moisturisation and healing process faster. It also stops the nipple from lying hard up against your maternity bra which then absorbs the Purelan more than your nipple does! Having your bra directly against the nipple immediately after breast feeding can also cause the still-damp breast to dry on the bra, which can hurt when you unstrap your bra and the nipple sticks to it.

Another product you can use to keep the bra away from your nipple are breast cups. They're also handy if your breasts are engorged, causing the nipple to lie flat, or if you have inverted nipples, as they surround the nipple and the pressure from your bra being closed draws the nipple out.  It you are using Purelan and Gladwrap you can still use breast cups over the top if you need to.

Keep using the Purelan and Gladwrap until your nipples are healed. You'll find that when you start breastfeeding the initial first 30-60 seconds will be uncomfortable, and then the pain will ease or go away. Note: Be careful also to make sure you use clean Gladwrap each time, and while Purelan is fine for baby, wipe it off the nipple before you feed to avoid stickiness.

Most of all, hang in there!