Sometimes a mom will get sore nipples after weeks or months with no problems. Following are six potential causes, plus some troubleshooting tips.
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Anytime you get sore or cracked nipples all of a sudden, check for thrush symptoms. Thrush usually causes pain in both sides.
Mastitis or a plugged duct or a milk blister is a possibility, particularly if only one breast/nipple or area of the breast is sore. It’s unusual to have mastitis, plugged duct, or a milk blister on both sides at once.
Are you ovulating or about to get your period? The hormonal changes at these times can cause sore nipples for a few days. Typically, both sides will be sore. Many moms of older babies are more bothered with latch on during these times, and it may feel as if baby is clamping down or scraping his teeth on the nipple, even though he doesn’t seem to have changed his latch. Mom may also feel generally uncomfortable and even irritated with nursing. Some moms get relief from the soreness by taking evening primrose oil or a calcium/magnesium supplement.
Any chance of pregnancy? Often the first sign of pregnancy for nursing moms is sore nipples. More here on pregnancy and nursing. As with soreness that comes with ovulation or menstruation, both sides will typically be sore since the soreness is caused by hormonal changes.
Has your baby been pulling on the nipple, biting, scraping teeth or leaving tooth indentations or practicing creative nursing positions? Any type of nipple trauma can cause soreness, and soreness may be on one or both sides.
Is baby teething? Many times moms experience nipple irritation as a result of teething. The increased saliva and the enzymes in it can irritate nipples. This can be lessened by rinsing the baby’s saliva off the nipples after the feeding. With teething, both sides would typically be sore.
Has baby started solids? Remnants of food left in baby’s mouth can also cause soreness. Rinse baby’s mouth or give him a sip of water before nursing.
Are you prone to getting eczema or psoriasis? Either can cause nipple soreness.
Are you using a new soap, laundry detergent, nipple ointment/cream, skin lotion, shampoo, powder, hair spray, perfume or deodorant? An allergic reaction to any of these might cause sore nipples.
Have you been exposed to poison ivy?
Latch and positioning
Any time you experience soreness, go back to the basics of positioning and latch just as you did in the early days. Even if you have not had problems with this in the past, latching/positioning can occasionally be a problem as baby gets older because older babies usually nurse in all kinds of positions, and the latch can get sort of “sloppy” too. One or both sides may be sore. Improving latching/positioning may be helpful even if there is another primary cause of the soreness. For example, many moms experience sore nipples when pregnant and although this has a hormonal cause, good positioning and latch can still improve the soreness to some extent.
Following are general treatment measures for sore nipples:
Treatment of Sore, Cracked or Bleeding Nipples by Becky Flora, IBCLC
Sore Nipples by Jack Newman, MD, FRCPC
Nipple Pain: Causes, Treatments, and Remedies by Jahaan Martin, from LEAVEN, Vol. 36 No. 1, February-March 2000, pp. 10-11.