Cracked nipples most often result from chafing during sports and due to breastfeeding.
Cracked nipples are characterized by red, irritated, and scabbed skin on or around the nipple. Using gentle creams and avoiding harsh soaps, chemicals, and tight clothing can help treat and prevent nipple cracking.
An estimated 38% of people who experience problems with breastfeeding or chestfeeding have sore or cracked nipples. This can make future breastfeeding sessions uncomfortable.
This article discusses why cracked nipples occur and how to treat them. It takes a close look at how to manage this symptom when breastfeeding, including pain relief and tips for preventing further damage.
Cracked nipples are most often due to nipple trauma. It can affect both men and women as a result of chafing against clothing or tissue damage from cuts or blows. It may be more likely if the nipples protrude more.
During breastfeeding, causes of cracked nipples include:
- problems with the baby’s latch
- not finding the optimal position
- not finding the ideal technique
- using a breast pump, particularly if the pump flange is too small
Cracked nipples are most likely to occur in the first month postpartum, according to an article in the journal BMC Pregnancy and Childbirth.
As a baby is learning to nurse, they may take additional time and effort to latch onto the breast. The friction can irritate and sensitize the nipple. The nipple can also become dry, leading to cracked skin and occasional bleeding.
Using a bottle to feed a baby before trying breastfeeding may also increase the chance of cracked nipples. This is because a baby will typically use a different sucking technique when using a bottle compared with a breast. If they are more used to a bottle, they may be more likely to cause nipple trauma.
If a baby needs supplemental milk in the early days or weeks of life, lactation consultants tend to recommend spoon, cup, or syringe feeding, rather than using a bottle. Using a spoon, cup, or syringe is less likely to have an adverse effect on the baby’s latch and long-term breastfeeding success.
To treat cracked nipples, a person can:
- Apply emollient creams, such as lanolin-based creams or coconut oil, to the nipples after breastfeeding. This can soften the skin and reduce cracking. Some people even apply breast milk to the nipples and allow it to dry, which can prevent cracking and has antibacterial properties.
- Apply a corticosteroid cream immediately after breastfeeding for no longer than 2 weeks at a time. Applying steroids for a longer time period could cause thinning of the nipple’s skin. Only try this if a healthcare professional has recommended it.
- Avoid wearing bras that are too tight, as this can increase friction on the nipples.
- Avoid using harsh soaps, deodorants, body powders, and other substances that could dry out the nipples.
Allowing time to heal and finding improved ways for a baby to latch onto the breast should also help cracked nipples heal.
A lactation consultant can help people struggling with breastfeeding to identify ways to improve the experience. This can enhance comfort and reduce nipple trauma that leads to cracked nipples.
Examples include evaluating:
- how the baby latches
- infant positioning
- parental positioning
- the nipple’s appearance after feeding
A lactation consultant can make recommendations after observing a feeding. They may suggest trying the following.
- Sit in a chair or in bed, leaning slightly back in a position that feels comfortable. Use as many pillows as needed to feel supported.
- Hold the baby “belly to belly,” so that the front of their body is against the front of the parent’s. The baby should not have to turn their head to the side to reach the breast.
- Before latching the baby, position them so that their nose is aligned with the nipple.
- Gently rub the nipple back and forth over the baby’s mouth. This should encourage them to open their mouth. Squeezing a little bit of milk or colostrum out of the breast can also help get the baby’s attention.
- Once the baby’s mouth is open, they should take the full areola into their mouth, not just the tip of the nipple. Generally, their chin will touch the breast first.
- If the baby’s latch starts to hurt, use a finger on the corner of their mouth, moving around the lips until their mouth breaks the seal.
If this approach does not work, try different hold options. Some examples include the “football” hold and the cradle position.
The “football” hold positions the baby’s body on the same side they are feeding from. Breastfeeding consultants often recommend this hold for people who had a cesarean birth, as the baby’s body will not cross the surgical incision.
The cradle position involves holding the baby in a cross-body position. A breastfeeding pillow, or a pillow underneath the baby, brings them up to breast height, and the parent will cradle the baby until the baby is securely against the chest and stomach. The baby should not have to turn their head to access the breast.
Nipple discomfort and tenderness is common when someone first starts breastfeeding or chestfeeding. However, taking the following preventive steps can help prevent cracked nipples:
- Ensure that the baby is adequately latching onto the breast. The nipple should be fully inside the baby’s mouth, with most of the areola in the mouth, too. A person should talk to a lactation consultant as soon as possible if they are not sure that the baby is latching well.
- Hand-express a small amount of breast milk before feeding the baby, so that the breasts are not engorged (overfull and hard). Breast engorgement can make it more difficult for the baby to latch well.
- Wash the breasts with warm water only and avoid using hard soaps to prevent dryness.
- Apply nipple ointment or allow breast milk to dry on the breasts.
- Consider wearing breast pads made from natural materials, as these can reduce friction on the breasts.
- Always allow the baby to come off the breast naturally.
Pain associated with breastfeeding is a common cause of stopping breastfeeding early, according to the Academy of Breastfeeding Medicine. Even if a parent has cracked nipples, they can usually continue to breastfeed while they heal.
To do so:
- Continue to vary nursing positions. This can reduce the stress on the nipples and help a person find a position that works best for them and their baby.
- Start by nursing on the side that is less sore until the breast milk letdown occurs. Then, switch to the other side, where the baby will not need to suck on the breast as hard because the milk will come out more easily.
- Apply breast milk or lanolin to the nipples after breastfeeding and allow them to air dry.
Sometimes, a lactation consultant might recommend using a silicone nipple shield for a while, to allow the nipples to heal without interrupting nursing.
If a person continues to experience cracked nipples, they can speak to their midwife or obstetrician, who may recommend seeking further lactation consulting or prescribe creams to help the nipples heal.
Cracked nipples can be a common side effect when establishing breastfeeding.
A person does not usually need to stop breastfeeding when they have cracked nipples, but this symptom might indicate that they need to improve the baby’s latch to reduce pain and enhance overall breastfeeding success.
If a person is concerned about cracked nipples or worried about infection, they can see their lactation consultant, midwife, or doctor for advice.