Sore nipples are very common, especially in the early weeks of breastfeeding.

Many mothers feel nipple pain that ceases after their baby’s initial attachment. If pain is felt beyond when your baby first attaches to your breast or if you notice any signs of nipple damage (e.g. cracks, blisters, bleeding), call an Australian Breastfeeding Association (ABA) counsellor and/or see a lactation consultant.

To prevent sore nipples from occurring, we should look to optimise the best positioning and attachment of our baby.

It would be wonderful if breastfeeding just worked ‘like that’ for every mother and her baby. But, like with any new skill, breastfeeding can take some time to get the hang of. The good news is that even after some early struggles, many mothers go on to breastfeed for many months or even years.

Like with most things, prevention is better than cure. Here are 7 ways to help prevent sore nipples:

#1: Attend An ABA Breastfeeding Education Class

Attending an ABA Breastfeeding Education Class before the arrival of your baby can help you prepare for the early weeks of breastfeeding and build a support network.

Thorough information about positioning and attachment, baby-led attachment, skin-to-skin contact and feeding cues is provided in the class. Learning about all these things can help prevent sore nipples.

#2: Skin-To-Skin Contact And Baby-Led Attachment Straight After Birth

Typically, straight after a baby is born, he is alert, eager and ready to receive his first breastfeed. Babies are hard-wired to instinctively find his mother’s breasts on his own accord (baby-led attachment).

Placing your baby on your bare chest after birth (skin-to-skin contact) helps him follow through on his instincts to find your breasts.

Skin-to-skin contact has other benefits such as:

Regulation of your baby’s heart rate, temperature and blood sugar levels
Helping you to learn your baby’s feeding cues

Skin-to-skin contact and baby-led attachment straight, or as soon as possible, after birth helps give your baby the most natural introduction to breastfeeding. By helping get breastfeeding off to the best start possible, it can help reduce the risk of sore nipples.

#3: More Baby-Led Attachment

Baby-led attachment helps lay down the foundation for breastfeeding. A baby who has many opportunities, particularly in the early weeks, to do baby-led attachment becomes a lot more orientated to his mother’s breasts.

Doing baby-led attachment as often as possible, particular in the early weeks, may help to reduce the incidence of sore nipples because it helps a baby learn how to attach optimally to the breast.

#4: Rooming-In

Rooming-in means having your baby with you at all times. If you’ve given birth at a hospital, it is policy in most hospitals that a mother and her baby are roomed-in together whenever medically possible.

Rooming-in is important for you and your baby get to know each other and to help you pick up on and respond to your baby’s early feeding cues (see below) which can reduce the risk of sore nipples.

#5: Feeding Your Baby When He Shows Early Feeding Cues

Early feeding cues include when your baby:

Turns his head from side to side with mouth open
Sticks out his tongue
Brings his hands close to his mouth
Wriggles
Makes squeaky sorts of noises

Feeding your baby when he shows early feeding cues is important to help ensure:

He gets the amount of milk he needs
You establish and then maintain your milk supply
He attaches optimally to your breast which can help prevent sore nipples. This is because a baby is typically calmer when his early feeding cues are responded to. When a baby is calm, his tongue tends to be in a better position (down and forward) to be able to better cup the breast and hence obtain a deeper attachment

#6: Optimise Positioning And Attachment

Positioning and attaching your baby well to the breast can take some time to get the hang of. Here are some tips to help optimise positioning and attachment:

When your baby is ready to feed, find a position that works best for you and your baby. Many mothers use the cradle or cross-cradle hold. For the cradle hold, hold your baby across the front of your body along your forearm – left arm for left breast, right arm for right. Your baby’s head rests in the crook of your arm. For the cross-cradle hold, hold your baby across the front of your body along your forearm – left arm for right breast, right arm for left. Support your baby’s neck and shoulder blades with your hand and wrist
Hold your baby in close so that his chest is touching yours
Make sure you bring your baby to your breast and not your breast to your baby, or you may end up with a very sore back
Bring his nose directly opposite your nipple
As he tips his head back, his top lip brushes over your nipple. This encourages him to open his mouth wide
When his mouth is wide open, bring your baby to your breast, aiming for your nipple to be pointing towards the roof of his mouth

There are many different breastfeeding positions. There is no ‘right’ one. Finding one that works best for you and your baby is important. Other breastfeeding positions include the football hold, cross-cradle, side-lying or breastfeeding in a semi-reclined position.

Your baby is attached well to your when:

He has a large mouthful of your breast in his mouth
His chin is in touching your breast
His nose is free, or just touching your breast
His lips are turned out, not sucked in
More of your areola is showing above his top lip as compared to his lower lip

If you have nipple pain that lasts beyond the initial attachment, you can try reattaching your baby. To do this, insert a clean finger into the corner of your baby’s mouth, between his gums. Gently but firmly press down on his lower gum to break the suction.

#7: Seek Help

Calling an ABA counsellor and/or seeing a lactation consultant can help provide you with information about correct positioning and attachment to help prevent sore nipples.

A lactation consultant can also check out your baby’s mouth anatomy to check for things like a tongue-tie that can increase the risk of sore nipples.