The key to nipple healing is to address the underlying cause, while treating
topically. This protocol has information about both aspects.
If you are nursing, try to latch your baby before they get hungry/frantic.
Pay attention to subtle feeding cues (“rooting,” lip smacking, etc.).
Short, frequent feeds are preferable to longer, less frequent feeds.
Deep latching is critical to decrease nipple soreness and allow healing to occur.
Here is my “Quick Start” Guide with the videos and pictures:[*] http://soundbeginningsfamily.com/quickstart/
If needed for areola fullness, you can use hand expressing, or reverse pressure softening, to make your tissue more supple or graspable. Here are some resources that include tutorials*:
- https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html
- https://vimeo.com/65196007
- https://kellymom.com/bf/pumpingmoms/pumping/hand-expression/
- An alternative may include brief (~1-3 minutes) pumping session.
If you need to support your breast/chest tissue during latching, pay attention to your hand position. Ensure that fingers are not in the area where baby’s chin will be when latching.
Steps to minimize pain and tissue trauma:
- Check latch periodically throughout the feeding
- If pain increases, release latch with your finger and re-latch.
- Try different nursing positions: laid-back/baby-led, koala hold, cross-cradle/cradle, football hold, and side-lying. This helps change the angle of the latch/compression.
- If necessary, based on pain level, begin on the least sore side. After let-down, switch to the more painful side and then finish on the less painful side.
- Using a nipple shield may be advised in the case of shallow and/or
painful latching. Resources about nipple shields:
Promoting Healing:
Your milk can support healing. Additional moisture can also be helpful.
I typically recommend using a topical emollient until your nipple tissue does not feel tender. Common choices include coconut oil, olive oil, purified lanolin, or a nipple balm/butter.
Avoid coconut and/or lanolin if you have any concerns about allergies. Consult with your health care provider before using nut oils, vitamin E, Bag Balm or petroleum-based products. Stop use of any products if your skin condition worsens.
If there is damage to your nipple, you may also consider occlusion with plastic wrap over the topical emollient, especially during any longer stretches between feedings.
As an alternative, you can apply a hydrogel or glycerin gel compress directly to sore nipple(s).
Change out anything that is touching your nipples (gel pads, damp nursing pads, etc.) frequently.
Other options we may discuss include: silver nipple cups, Medi-honey (must be the sterile/irradiated version to eliminate the risk of botulism), and/or All-Purpose Nipple Ointment (APNO) which contains an antibiotic, antifungal, and corticosteroid. Due to the corticosteroid, use of APNO should be judicious and short-lived to avoid side effects including thinning of skin.
If there are cracks or openings in the nipple, consider daily saline soak and/or washing with a gentle soap to avoid bacterial biofilm build-up until the nipple is completely healed.
More info here*: https://kellymom.com/bf/concerns/mother/nipplehealing/
If needed, consult with your healthcare provider about an anti-inflammatory pain reliever.
If your pain or nipple damage is worsening, or not showing signs of healing within 24-48 hours, please reach out for additional support.[†]