Nipple pain is a common complaint amongst breastfeeding mums. Most women experience it at some stage during their breastfeeding relationship with their baby.

However, it is important to know that despite it being a common problem, it can be a sign that there is a problem and the problem if left untreated can lead to problems that are more serious.
Birth to Three Months
During the early stages of a baby’s life, nipple pain can have a number of causes.

  • The most common cause is incorrect positioning baby on the breast. If your baby does not attach to the breast properly, you will likely develop a sore area, abrasion or ulceration on your nipple.
  • Nipple confusion and incorrect sucking technique may also traumatise your nipple and create pain.
  • Soggy breast pads can cause inflamed and sore nipples that are prone to abrasions, ulcerations and portals for infection.
  • Sore nipples may be the first sign of serious infections including thrush and bacteria that can cause mastitis.
  • Dermatitis and eczema may develop around the nipple area, particularly if you are prone to these skin problems before your baby’s birth or you develop sensitivity to products such as washing detergents or soaps during and after pregnancy.

As your baby reaches four to six months of age, any of these problems may still appear or continue to cause you problems. Your baby’s teeth will typically begin to erupt around this age group and he may begin to play with and bite your nipples, especially towards the end of a feed.

How to Prevent and Treat Sore Nipples and Prevent Breast Infections

1. Before you have your baby, learn the many different positions you can feed your baby. Learn the physiology of breast feeding to ensure you know the correct placement of your baby’s mouth and do experiment with different positions until you find one that is comfortable for both of you. Ask a midwife, Child Health nurse,  lactation consultant or breast feeding counsellor to observe you feeding and help you if you experience any problems with position or attachment.
2. If possible, try not to introduce a bottle to your breast fed baby. The sucking technique for breastfeeding is different to that of bottle feeding and can lead to sucking trauma. If you choose to offer alternatives, try using a dropper, spoon or cup in preference to a bottle to reduce the chance of nipple confusion development. Your Child Health Nurse or breast feeding counsellor can help you learn how to feed using these methods.
3. If you find yourself leaking breast milk often, do change your pads regularly and don’t forget to let them air between feeds by sitting with your breasts exposed for a few minutes after you finish feeding. Wash your breasts gently with warm water and then smear a little hind milk on them. This sanitises them and reduces the opportunity for bacteria to enter. If you have an ulcer or abrasion on your nipple, do this often to give it chance to dry and heal. Soggy wet pads are the perfect environment for bacterial and fungal infections to multiply and produce infections in your milk ducts.
4. Nipple and breast infections can be identified by three main signs. (Pain, redness and heat over the infected area…) You may also have a discharge or evidence of a white flaky substance on your nipples that may indicate infection.
If you develop any of these symptoms talk to your health or breastfeeding advisor immediately. Delaying help may make the problem worse. If you notice a white flaky substance this may be a thrush (Candida infection). It’s likely your baby may also need treatment for oral thrush, which passes easily between your baby’s mouth and your nipple and must be treated.
If you have swollen, hot, lumpy breasts and flu like symptoms, please seek medical help immediately. It is likely you may have or be at risk of developing mastitis (breast infection) that will quickly cause serious health problems if untreated. Your breast feeding advisor can help you learn how to prevent mastitis developing.
5. If you develop or have a pre existing problem with dermatitis, eczema or other skin condition and it flares during feeding, stop using creams and other topical ointments around your breasts, wash only with warm water and a gentle natural unperfumed soap. Wash your undergarments regularly and change your breast pads very regularly. If possible, include longer and regular periods where you do not have to wear a bra.
Dietary changes and topical steroids may also be necessary to prevent serious and very painful eczema developing. Your health professional can guide you to the best options, but do seek help as soon as any of these conditions develop.
6. If your baby starts to bite, he will usually do it towards the end of a feed. Do not allow him to play on the breast, but remove him as soon as he finishes feeding. Babies often get a “cheeky” look in their eye when they are going to bite and you will soon notice the signs. You may like to tell him “no” sternly and remove him from the breast. If he is sucking and biting, remove the suction before you remove him from the breast. If he hasn’t finished feeding, or cries for more, offer the breast again and repeat the process each time he tries to bite. Babies usually grow out of this stage.
If he has sore gums due to teething, ensure you give him cold teething rings and discuss with your medical advisor how best to alleviate his pain before a feed.
We will publish an article on biting and breast feeding to address this common issue in the near future.
This article was written by Carol Groves:  Carol trained and worked as a nurse and midwife in Australia and overseas, many years ago before having children. Later I trained and worked as a breastfeeding counsellor with Nursing Mothers (now Breastfeeding Australia). Today I am preparing to be a Doula (Childbirth and Peri natal Support Person) and Mother’s Helper. My website is being developed at

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