Sore or cracked nipples are caused when a baby is not attached to the breast properly and suckles at the nipple rather than the breast. The skin on the nipple can get easily grazed or cracked by one or two poorly attached feeds.
To help visualise what is happening to the nipple when a baby isn't attached well at the breast try sucking one of your fingers and feel the pressure this creates against your hard palate; your finger will soon become red and if you suck it for long enough it can get quite tender.
To ensure good attachment a baby's mouth should be open very wide, almost like a yawn, as he comes to the breast this will ensure that the mother's nipple reaches the back of the baby's mouth, at the soft palate. The baby scoops the nipple and breast into his mouth then uses his tongue and jaw to 'milk' the breast.
Here are a few pointers to ensure good attachment:
- Make sure you are sitting comfortably with your back well supported.
- Pull your baby in close to you and hold his whole body facing you, with his nose and mouth about the level of your nipple
- You may have to tease his mouth open by stroking his face
- His ear, shoulder and hip should be in a straight line and his body should be well supported
If your nipples do become sore or cracked:
- Your midwife, health visitor or volunteer breastfeeding supporter will ask to watch your baby take a full breastfeed just to ensure his position and attachment are good, even small changes in the position can bring immediate relief from nipple soreness
- Encourage the milk to flow (as above)
- Try expressing a little breast milk and rub gently into the nipple at the end of the feed.
- Start feeding on the least painful breast first
- Make sure the baby's mouth isn't dragged off the breast at any time.
Don't forget that your local breastfeeding support group can also offer you help and advice.