Hi mamas, I’m Stephanie Weight Hadfield, an International Board Certified Lactation Consultant (IBCLC) and mom of 4. I’m here today to share a guide to caring for your nipples before and during breastfeeding. This nipple care guide will help prepare you for breastfeeding with confidence!
At Lactation Link, we get lots of questions from mamas wondering if they need to do anything special during pregnancy to prep their nipples for breastfeeding, or if nipples need special care or cleaning once baby is here. The quick answer is no. The nipple and areola (pronounced air-e-O-la, it’s the darker pigmented area that surrounds your nipple) can do a pretty good job taking care of themselves.Because of this, our nipples do not need any special nipple care during pregnancy. You don’t need to do anything to disinfect your nipples and you definitely don’t need to “toughen them up”.
You may have noticed small bumps around your areola that became more prominent during your pregnancy and might be especially noticeable when you’re cold. These are called Montgomery glands and they secrete a substance that is anti-bacterial and naturally moisturizing. This substance also smells similar to your amniotic fluid, so it can help babies find the nipple and latch right after birth (1). Isn’t that amazing?! As long as you don’t have any cracking or damage to your nipples, they don’t need any special nipple care through washing or disinfecting beyond your normal bathing routine.
Basic Nipple Care
- Make sure your baby is latching well. A deep, comfortable latch is your first defense against nipple pain and damage, and will also help your baby get more of your milk. Lactation Link’s online breastfeeding courses include in-depth information on how to position baby for the most comfortable and effective latch. You nipple care routine will be rather short if baby is latching well!
- Pain is not normal. Nipple pain is your body’s way of telling you that something needs to change with the latch. Some tenderness is normal during the first couple of weeks. However, pain that lasts longer than the first 30 seconds of a latch or is severe, is a sign that you need to unlatch baby and try again. If you’re not able to get your baby to latch comfortably, get help. Continuing to nurse through pain can cause nipple damage like cracking, bleeding, blistering and infection. With qualified lactation help, breastfeeding will get better!
- Change your breast pads often to keep your nipples from sitting in an over-wet environment. Think of what happens to your fingers and toes when you take a long bath– they get wrinkly as they absorb extra water. The same thing can happen to your nipples if they are exposed to soggy breast pads for long periods of time: it leads to chapping and skin breakdown.
Caring for Tender or Damaged Skin
If you already have painful skin damage like cracking, blistering and bleeding, get qualified, in-person help, preferably from an IBCLC. We would love to help, with either an eConsult or an in-person consultation if you are in our area. Tips to healing and nipple care will not do any good if the latch is still causing damage every time baby feeds. In the meantime, here are some quick tips to help you find some relief:
- Offer the uninjured or less injured side first until the milk releases. Once you see your baby swallowing actively, then gently move your baby to feed on the more painful side. This can help because babies tend to have a stronger suck at the beginning of a feeding session when they’re trying to stimulate the flow of milk. If both sides are painful and sore, you can stimulate a letdown by expressing a small amount of milk before putting your baby to the breast (2).
- Talk to your healthcare provider about taking an over-the-counter pain reliever. Ibuprofen (Motrin, Advil) is a good choice because it relieves inflammation in addition to pain and is generally considered compatible with breastfeeding.
- Wash your hands carefully before every feeding (singing the alphabet song in your head can help get the timing right). If you have any cracks or breaks in your skin, gently wash your nipples and areolae twice each day with a mild, non-perfumed, non-antibacterial soap until the broken skin is healed. Breaks in your skin are an entry point for germs to enter the breast and cause infection. Careful hygiene is one of the best ways to reduce the increased risk of mastitis that comes from having damaged nipples (3).
- Provide a moist healing environment. This is different than the soggy surface wetness I mentioned above. Wound care experts have found that wounds heal faster and with less pain when the natural internal moisture of the skin is protected (4). Moist wound healing techniques have also been found to reduce pain because they protect exposed nerve endings (5). There are many products on the market designed to provide moist healing for breastfeeding mothers, like hypoallergenic purified lanolin ointments or hydrogel pads. Apply these products after every feeding session to maintain consistent protection until your skin is healed.
- Contact your healthcare provider if you have any signs of infection: inflammation/redness, swelling, oozing or pus. A variety of rashes can also cause nipple pain, so see your healthcare provider if you have flaky, red, itchy, shiny and/or irritated skin that extends to your areola.
Remember, nipple pain and/or damage is not normal: it’s a big red flag that you need competent and compassionate clinical breastfeeding support. If you live in Utah between Payson and Ogden, one of Lactation Link’s International Board Certified Lactation Consultants (IBCLCs) can come to your home to assess your baby’s latch and the cause of your pain. If you live outside of our area, you can find an IBCLC in your area, by clicking here.
More articles on nipple & breast care from Lactation Link:
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Stephanie Weight Hadfield, BS, IBCLC
- Doucet, S., Soussignan, R., Sagot, P., & Schaal, B. (2009). The secretion of areolar (Montgomery’s) glands from lactating women elicits selective, unconditional responses in neonates. PLoS One, 4(10), e7579.
- Mohrbacher, N. (2010). Breastfeeding answers made simple: a guide for helping mothers. Amarillo, TX: Hale Pub.
- Genna, C. W. (2009). Selecting and using breastfeeding tools: improving care and outcomes. Amarillo, TX: Hale Pub.
- Hinman, C. D., & Maibach, H. (1963). Effect of Air Exposure and Occlusion on Experimental Human Skin Wounds. Nature, 200, 377-378.
- Mertz, P.M. (1990). Intervention: Dressing effects on wound healing. In: W.H. Eaglstein (Ed.), Wound care manual: New directions in wound healing (pp. 83-96).