Superficial Pain

Superficial Pain / Intact Skin - No wounds 

If you have wounds, cracks, scabs, rashes or any other form of skin breakdown, please refer to those articles.   

Definition:  Discomfort of the nipples and areolae during or after feeding/pumping without wounds  

Many women experience nipple pain in the first 1-2 weeks of breastfeeding.  If pain continues past this time, there is something wrong and you need to get help. 

Most common causes of soreness in nipples that do not have open wounds:

• shallow latch
• shape of  the baby’s mouth/tongue (tongue tie, high palate)
• overactive letdown or high flow
• yeast infection
• inflamed duct 
• pump trauma
• vascular spasm  

Latch: 

Ideally you want to get as much breast tissue in the baby’s mouth as possible. Aim the nipple at the baby’s nose so the baby opens wide.  You then guide the baby on in a way that the nipple ends up closer to the roof of the baby’s mouth and more of the bottom part of the areole will be in the mouth.  You want the tongue to compress the areolae and not the nipple.  When open wide, the angle at the corner of the mouth should be 90º or more. Look at the nipple when the baby comes off the breast. If the nipple is round (without a crease or fold at the tip), the latch was probably good.  If you need help latching your baby on comfortably, see a lactation consultant. 

Nipple Compression:

Sometimes, even with a good, deep latch, the baby may compress the nipple and cause pain.  In this case, you will see a compression line, crease or fold on the nipple tip.This may happen if a baby has a tight frenulum (tongue tie) and/or a high palate.Also, when the flow of milk is too fast, the baby may compress the nipple in order to slow down the flow (see overactive letdown).