Nipple Pain and Breastfeeding

Nipple pain during breastfeeding is a common reason for parents to seek lactation support, reduce how often they breastfeed, or, in more difficult cases, stop breastfeeding altogether. It is important for breastfeeding parents to know that nipple pain or damage is not a normal part of breastfeeding. You do not need to “toughen up” your nipples to breastfeed.

Some initial discomfort can happen as you and your baby learn positioning and latch. Because newborns feed frequently over a 24-hour period, there are many opportunities to practise and improve the latch within the first few days.

Common Causes of Nipple Pain While Breastfeeding

• Positioning and latch: This is the most common cause of nipple pain during breastfeeding. A shallow latch can leave the nipple compressed after a feed, sometimes making it look flattened or shaped like a lipstick. If pain occurs, gently unlatch the baby, reposition, and try again. Support from an IBCLC can make a significant difference by helping you adjust positioning and improve latch.
• Infant oral anatomy or tension: Tension or oral restrictions in the baby can affect latch and milk transfer. A newborn oral assessment can be helpful while you are working on positioning and latch with an IBCLC. If a concern is identified, gentle interventions, such as bodywork, may support feeding. It may also help with the baby’s comfort, sleep, and digestion. In some cases, additional care may be needed to address the baby’s oral anatomy.
• Ill-fitting pump flanges or bras: Breast pump flanges or bras that do not fit well can irritate or damage the nipple or the breast tissue, making breastfeeding, pumping, or even light touch more painful. Correctly fitted flanges can also help improve pumping comfort and output.
• Milk blister or bleb: A milk blister is a small, tender white area on the nipple. It can be related to inflammation that blocks milk flow and prevents part of the ductal system from draining well. An IBCLC can help identify possible causes and support steps to improve drainage.
• Yeast, thrush, or allergic dermatitis: These causes of nipple pain are less common but should be considered if nipple pain continues, worsens, or is accompanied by itching, burning, or skin changes. With thrush, both the breastfeeding parent and baby are typically treated.

When to Seek Support

Seek medical advice if nipple pain continues for more than a couple of days, if there is visible nipple damage, or if the nipples change colour or shape, become increasingly uncomfortable, or feel itchy.

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Mélanie Jacobson ND IBCLC is a Toronto-based Naturopathic Doctor and Lactation Consultant. She focuses on breastfeeding education, and supporting families with breastfeeding, bottle feeding, combo feeding as well as solid food introduction. She is available for home, clinic and virtual visits. You can book your free 15 min meet and greet consultation right here to discuss her services and approach.