Why does breastfeeding hurt? Sore nipples, and what actually helps

"Everyone said it would hurt at first." I hear this so often, usually from a mother who's been in pain for two weeks. Here's the truth: a little tenderness in the first few days is common. Pain that lasts through the whole feed, or keeps getting worse, isn't something you should just put up with.

What's normal, and what isn't

In the first week, many mothers feel a strong tug or a sharp twinge for the first 20 to 30 seconds of a feed, which then settles. That usually eases off within a week or two.

What's not normal:

• Pain that lasts the whole feed
• Cracked, bleeding or blistered nipples
• Nipples that look flattened, creased or white after feeds
• Toe-curling pain that makes you dread the next feed

The most common cause: a shallow latch

Nine times out of ten, sore nipples come down to how the baby is latching. If your baby takes only the nipple instead of a big mouthful of breast, the nipple gets squeezed against the hard palate at every suck. It's a bit like a shoe that rubs in the same spot all day.

A deeper latch often brings relief within a day or two. I've written a step-by-step guide to a deep latch that walks through it.

Other causes worth checking

• Positioning: a baby whose head is turned or who's lying too low drags on the nipple.
• Tongue tie: a tight band under the tongue can stop your baby from latching deeply.
• Pulling baby off without breaking suction: always slide a finger in first.
• Engorgement: very full breasts are hard to latch onto. Express a little first.
• Pump problems: a flange that's the wrong size, or suction set too high.
• Infection: burning or shooting pain, or a shiny, flaky nipple, can mean thrush or a bacterial infection. Please see your doctor.

Fix the cause, not just the symptoms. Creams can soothe, but they can't fix a latch.

What helps while you heal

• Start feeds on the less sore side, then switch once milk is flowing
• After feeds, rub a few drops of your own milk onto the nipple and let it air dry
• A thin layer of purified lanolin can help cracked skin stay moist
• Wear a soft, loose cotton bra, and change breast pads often
• Try a different position. It changes where the pressure falls.
• If feeding is too painful for now, hand express or pump to protect your supply, and ask for help quickly

When to get help

If pain hasn't improved within a few days, if your nipples are cracked or bleeding, or if you have a fever or a hot, red area on the breast, please don't wait. Pain is the most common reason mothers stop breastfeeding earlier than they wanted to, and it's usually fixable.

I can watch a feed in person or on a video call and usually find the cause quickly. Book a consultation, or send me a message.

General information only. For fever, a red or hot breast, or signs of infection, see your doctor.