• You can expect discomfort with breastfeeding that you may describe as “tender or sore.”
  • When the baby first latches on, take a deep breath, because it can be intense.  After about 30 seconds, you should describe the sensation as “pulling or tugging,” not “pinchy, biting, or excruciatingly painful.”
  • Your nipples may look a little pink or chaffed in the first week or two.  By the end of the first week, your nipples should be getting better, not worse.
  • You should find that using Lanolin or a non-Lanolin substitute such as Earth Mama Angel Baby Nipple butter is soothing after feedings and helps your nipples feel ready for the next feeding.


  • If you describe nursing as “extremely painful, toe curling, excruciating, or very pinchy.”  Unlatch and try again.
  • If your nipples are cracked, bleeding, or have open wounds.
  • If after a week your nipples are getting worse, not better.
  • If Lanolin or a non-Lanolin substitute feels like it isn’t doing anything to help your nipples at all.


  • Something isn’t right with your latch or a few bad latches have damaged your nipple tissue and it is taking time to heal.


Everyone should use the following techniques:  Express, Air, Lanolin

  • Wash your hands before every breastfeeding session.
  • Express your own milk onto your nipples and let air dry.
  • Apply a pea size of Lanolin or Lanolin-free nipple cream.
    • Warm the cream up in your fingers before applying for easier application.

CARE FOR SORE BUT INTACT NIPPLES (no cracks or bleeding):

  • Use general nipple care: Express, Air, Lanolin
  • Seek the assistance of an International Board Certified Lactation Consultant (IBCLC) ASAP to fix the latch and rule out any other problems.
  • Ask your Midwife, OB, or IBCLC if All Purpose Nipple Cream, a prescription strength nipple cream, is right for you.
  • Allow open air time to nipple whenever possible if it feels good. If it is more painful to have them open to air, apply a clean breast pad and a well-fitting bra. 

CARE FOR SORE, CRACKED NIPPLES: If you have ANY open wounds on your nipples, follow these guidelines:

  • Always wash your hands before touching your nipples!
  • After breastfeeding, cleanse nipples well with normal saline solution.
    • The easiest way to do this is with infant saline nose drops.  You can also make your own solution and drip it onto your nipples with a cotton ball.
    • To make your own saline solution, mix half a teaspoon of sea salt in eight ounces warm water. Dilute the salt well. This shouldn’t sting! If it stings, you used too much salt.  Do not contaminate the solution by reintroducing a dirty cotton ball or dirty hands. Make a fresh batch daily.
    • After cleansing with saline, express your own milk onto your nipples and let air dry or pat dry with a clean piece of gauze or cotton ball. 
    • Apply All Purpose Nipple Ointment (prescribed by your healthcare provider) or Lanolin.
    • Apply a clean breast pad (think of this as a clean bandage).

Can’t bear the pain of breastfeeding anymore? You always have the option to pump in place of feeding.

When to seek help…

Make an appointment with an International Board Certified Lactation Consultant if:

  • You can’t get a comfortable latch.
  • You have open cracks or wounds on your nipples.
  • There are lumps in your breasts that aren’t softening even after multiple nursing sessions (this is probably plugged ducts).
  • Engorgement lasts for five or more days after the birth of your baby.

Call your Midwife or OB ASAP if…

  • You spike a fever of 100.4 or higher (this is probably mastitis).
  • You feel flu-like symptoms, chills, body aches (this is probably mastitis).
  • You have a very painful, red, warm lump in one or both of your breasts  (this is probably plugged ducts)

Still pregnant?

If you are local to the Wilmington, DE area, I would love to see you in one of the Breastfeeding Basics classes we offer at The Birth Center. 

If you aren’t able to join me live, check out the online education program I created- The Pregnant Mama’s Guide to Breastfeeding Success

Currently nursing?

Come see me or one of my fabulous colleagues at The Birth Center in Wilmington, DE. Let us take the time to teach you about your own unique baby and breastfeeding relationship during a one on one consultation.