Tender and sensitive nipples are common as you begin
breastfeeding your new baby. However, very sore, cracked, blistered or
bleeding nipples are not normal. Usually this problem is related to the
way your baby attaches or "latches-on" to your breast. It is important
that your baby get a big "mouthful" of your nipple and areola (darkened
area of the nipple) when latching-on to your breast.
Here are some helpful hints:
 Vary the
position you hold your baby in at each feeding. Try the cradle or
cross-cradle hold one time and football hold or side-lying the
next. |
| Stimulate your let-down reflex before breastfeeding
your baby by massaging and stimulating your breasts and nipples.
Breast massage during the feeding will also help the milk flow more
quickly and easily. |
| Start your baby on the least sore breast. Limit the
time your baby feeds on the sorest nipple. |
| Use a light application of purified lanolin on your
nipples. A droplet of your own breast milk massaged into your nipple
and areola works well too. |
| Avoid use of soaps, alcohol or other drying agents on
your nipples. Water is all that is needed to clean your breasts when
bathing. |
| If your breasts are very full and hard (engorged), hand
express a little milk or use a breast pump before your baby
breastfeeds. This will make your nipples easier to grasp for your
baby. Refer to the reverse side of this sheet for details on how to
treat engorgement. |
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Breast shells may help your sore nipples during the healing
process. Shells promote the circulation of air around your nipples
and keep the pressure of the bra off your nipples. Wear shells
between day feedings but not during the night. Don't confuse these
with nipple shields, which are only recommended for special feeding
situations. |
| Do not allow breast pads to "stick" to your nipples.
Removing them can further injure your nipples skin. If necessary,
moisten the pads to help loosen them before removing. |
| Release your baby's suction before removing him from
your breast. Generally, your baby will spontaneously release from
your breast when he is finished feeding. However, if he is improperly
positioned or needs to be removed, break the suction by gently
sliding your clean finger between his lips and gums until you feel
the release. |
| Hydrogel dressings may be helpful if you have broken
skin on your nipples. They help promote the wound healing with
moisture. Check with a Board Certified Lactation Consultant to
determine if these dressings are appropriate for your situation. |
Soft hydrogel padsprovide cool, soothing
relief for mothers who may be experiencing nipple pain or trauma
associated with breastfeeding. Learn
more ...
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Engorgement |
Sometime during the first week
after delivery, your milk will "come in". This means your milk volume
increases from colostrum, or early milk, to mature milk. Your body may make
more milk than your baby needs during these first few weeks, and it is easy
for your breasts to become over full (engorged).
To prevent engorgement:
 Breastfeed frequently, about 8-12 times per 24 hour
period.
Make sure your baby latches-on well so he will empty your
breasts effectively. Refer to the Ameda Answer Sheet "How Do I Hold My Baby
While Breastfeeding?" for details.
Do not skip feedings or substitute formula feedings during
the first several weeks.
For moderate engorgement:
(Breasts feel as firm as the tip of your nose)
Apply warmth or heat before feedings to soften your breasts
and encourage the let-down reflex.
Allow warm water to run over your breasts in the shower.
This often feels good and encourages your breasts to begin leaking
milk.
Try gentle breast massage. Make circular motions in small
areas with your finger tips moving your hand all around your breast, then
lightly stroke from your outer breast inward toward your nipple.
Manually express some milk. Place your hand in a "C"
position on your breast, fingers under your breast and thumb on top.
Position your fingers about 1" to 11/2" from the base of your nipple.
Gently push back towards your chest, then roll your fingers towards your
nipple. Repeat several times, then rotate your hand around your breast to
drain all areas.
Apply cold compresses after feedings to reduce any swelling and provide
comfort. You can use soft gel-like ice packs or bags of frozen peas wrapped
in a lightweight towel. Apply to your breast for 10 - 20 minutes. |
For extreme engorgement:
(Breasts feel as hard as your forehead)
Apply cold compresses to your breasts, no heat. This
will help reduce swelling and slow the re-filling of the breasts while
providing some comfort.
You can use a breast pump for a few minutes to remove
some milk from your breasts before feedings. This will help soften and
shape your nipple to make it easier for your baby to latch on.
If your baby doesn't empty your breasts sufficiently
during feedings or only feeds on one breast, you may need to use a
breast pump after feedings for a day or two.
 It is important to
manage severe engorgement with adequate milk expression techniques to
prevent a low milk supply later in your breastfeeding experience.
Another remedy that may provide relief for severe engorgement is to
apply green cabbage leaves to your breasts between feedings. Although
this may sound like an unusual treatment, many women have found it
effective in relieving the pain and to reduce swelling. Place a chilled
cabbage leaf in your bra for 15-30 minutes, 2-3 times per day or until
your breasts begin to soften. Do not use this treatment more than 2-3
times per day as it can greatly reduce your milk supply. Do not use if
you are allergic to cabbage, sulfa drugs or develop a skin rash.
It is important to treat engorgement before your breasts become very
full and painful. This severe pressure and swelling can signal your
milk producing cells to greatly reduce your milk supply. If, despite
using these methods, you cannot obtain relief, seek help from a Board
Certified Lactation Consultant or other knowledgeable health care
provider.
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