Think pierced nipples and you get an idea of what cracked nipples feel like. To avoid this tear-jerking experience (that happens to just about every first-time breastfeeding mom) getting the baby to latch properly and using a good nipple cream is essential. When cracked nipples are neglected, it could be the end of breastfeeding.
Breastfeeding is a great ‘bonding’ experience, but the pain caused by cracked nipples can send negative volts searing through your body. Baby senses this and fusses at the breast and doesn’t feed properly. Breasts can become engorged. Painful nipples quickly become as hard thimbles and the baby struggles to latch.
Because breasts make milk according to demand, when this is low, milk production is low, and gradually becomes less, until it literally ‘dries up’.
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What do cracked nipples look like?
Pregnancy changed your nipples. They became bigger and darker, with little glands surrounding the nipple (the areola) called the Montgomery Tubercles. These make a special lubricant that moisturises and helps to prevent nipple infections.
Pain, especially at the start of a feed, is the first sign of cracked nipples. This pain usually eases once the milk starts to flow. When pain persists, it means that the crack is worsening. When you see blood, it’s time to get professional help.
What causes cracked nipples?
Cracked nipples are mostly caused by incorrect latching and thrush.
Newborns may be a bundle of instincts and reflexes, but it’s a fallacy that they know what to do. Babies need to learn the sequence of sucking, swallowing and breathing. They get a few days to learn how to do this before mature breast milk ‘comes in’, and the breasts are still soft. By day three, they need to know how to feed properly.
Babies traumatise the nipple when they ‘bite’ onto it. This is incorrect latching, and when it happens, you need to gently ‘break’ the baby’s suction by putting your little finger into the corner of his/her mouth, and starting again.
Thrush often begins with a nappy rash. Candida can be transmitted from your hands to the baby’s mouth, and from the baby’s mouth to your nipples. It can also be caused by wet breast pads – especially when they’re plastic-lined. Thrush needs to be treated with anti-fungal medication.
What to do when you have cracked nipples
Treat cracked nipples quickly to prevent complications. Cracks can become infected and, when serious, this can become mastitis (engorged breasts) and, worst-case scenario, become a breast abscess.
- Bathe your breasts in hot water before feeding. Dry well
- Position your baby’s tummy against your tummy so that baby is looking at your nipple
- After feeding dry your nipples well and expose them to fresh air 5 – 10 minutes
- Try placing wet rooibos teabags over your nipples after feeding. These help to soothe and heal cracked nipples
- Change your breast-pads regularly – especially when they’re plastic-lined
- Serious infections may need antibiotics
- It may be helpful to express breast milk and feed your baby with a bottle while your nipples heal
- Ask your healthcare provider to recommend a nipple cream. This needs to be washed off before feeding. Breastmilk can also be rubbed onto the nipple
- Don’t smother your nipple glands with ‘waterproofing’ like Vaseline. This blocks natural lubrication, and the petroleum content can be harmful to the baby
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Preventing cracked nipples
The secret to ‘successful breastfeeding’ is ‘successful latching’. Here’s how:
- Take your time – babies don’t like to be rushed
- Brush your nipple against the baby’s cheek. This stimulates the ‘rooting reflex’ and encourages the baby to open his mouth wide to feed
- Stimulating the nipple activates erectile tissue, preparing them for feeding
- Tease the baby’s mouth with your nipple, and wait for the baby to open his mouth. Then bring baby’s mouth towards the nipple – not the other way round
- During feeding, the baby’s mouth should take as much of your areola in his mouth as possible
- Baby’s tongue should be under your nipple
- You shouldn’t need to feed your baby for more than 10 minutes at each breast. Your nipple is not a dummy
Always wear a comfortable bra. Try wearing a cabbage leaf inside your bra when your breasts feel full and uncomfortable, with an opening for your nipple.
Breastfeeding can be difficult for women who have had a c-section. Try holding the baby under your arm like a football. Or you can use a pillow on your lap to support your baby during feeding.
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