June 3, 2023

earth mama

When a girlfriend confided in me that breastfeeding her daughter was more painful than labor and delivery, I balked at the notion. How could that be possible? I thought. Surely, a snuggly baby suckling at the breast could not be as painful as pushing out a bowling ball-size human or getting your stomach cut open. Alas, a decade later, when I finally gave birth to my baby girl and experienced it all first-hand, I understood. Breastfeeding is a beautiful, natural experience—but yes, the beginning can be pretty uncomfortable and challenging.

Moms in the thick of it, during those early days, are overcome with hormones. We have to worry about the baby gaining immediate weight, getting to know a little person who is still adjusting to the world, and taking care of our exhausted postpartum-self. Nursing, in theory, should be easy. It’s innate and instinctual. Our bodies are meant to do it. That said, it’s okay if that’s not exactly how your story goes. I remember crying to my husband and the nurses the first night of my daughter’s life because I didn’t understand how to get her to latch.

It was quite painful and overwhelming.

Nursing, in theory, should be easy. It’s innate and instinctual. Our bodies are meant to do it. That said, it’s okay if that’s not exactly how your story goes.

The following two weeks were a battle: me against my breasts. My nipples were sore, cracked, and bleeding—a common side effect of nursing if the baby is not latching correctly. After a quick call to a board-certified lactation consultant and a big Amazon Prime haul to get the balms, pads, and supplies I needed, the situation improved. Looking back on the journey, I am so grateful I stuck with it. Truthfully, I loved nursing my daughter. And I also loved allowing others—my husband, my mother, and our nanny—to step in and feed my daughter formula or bottled breast milk.

“No one said to me—even as a doctor—that it really hurts at first,” shares Dr. Amy Wechsler, a New York-based double-board certified dermatologist, psychiatrist, and mother-of-two., “There was this sense that it [was supposed to be a] beautiful, amazing, bonding [experience]. At first, I was like, ‘Am I doing something wrong? Is it just me?’ I am sure it’s more known now. But, 22 years ago, I wasn’t able to get all of these great online resources.”

I ended up nursing my daughter for 14 months, though not exclusively. We also gave her formula, starting from day one. While nursing was one of my favorite parts of my daughter’s first year of life, it was not easy (especially in the beginning).

She also dealt with cracked, bleeding nipples. “I remember I was crying at one point,” she says, “It was so much harder the first time because it really is a learned skill. I knew much earlier what to do if he [her second child] wasn’t latching properly. Whereas with my first, I didn’t know.” She eventually sought out a lactation consultant to help.

Ahead, Wechsler and board-certified lactation consultant and labor support doula Ayelet Kaznelson weigh in on why nipples bruise from nursing and how to heal them. Additionally, I discuss the one skincare trick that soothed my own battered nipples.

Why Do Nipples Crack and Bleed When Breastfeeding?

There are several reasons nipples bruise so easily during the early phase of nursing—one being how sensitive the skin is. “The skin around the areola of the nipple is pretty thin,” Wechsler explains. “There’s a lot of suction and force from the baby’s mouth, and it’s repeated suction. If it were just once, you’d be fine. But it can be every two hours. This doesn’t give the skin a chance to heal.”

She also notes that the skin is sensitive without it being sucked on. “The skin that is around the nipples and the mouth has the highest concentration of blood vessels and nerves. So, you know, it hurts.”

Wechsler, who breastfed her two children, was told to start nursing on the breast that’s less sore and then alternate. Some women have an “easier” side for the baby to latch onto (I found this to be true, and it was obviously my bigger breast). Be wary of not overusing that side, though; you want to switch it up to keep your supply even.

According to Kaznelson, an incorrect latch is the top reason nipples can get beat up. “[Nipples crack and bleed] because the latch is not correct,” she notes. “When the latch is deep and good, we really shouldn’t have an injury. Maybe we can have slight discomfort or a little sensitivity, but nothing you would ever think to quit over.”

When you’re trying to get your baby to latch or find a comfortable position to nurse, it’s challenging to think about anything else. It’s important to know that if it feels truly terrible, something is wrong. Kaznelson explains why this happens concerning the latch. “The baby’s tongue can be chafing the nipple because it’s too close to it,” she says. “If the baby isn’t latched deeply, they have a harder time accessing the milk. And so, sometimes they compensate for it by using their gums and jaw, which then will compress the nipple.” To put it simply, your baby could be bruising you because your nipple isn’t in the right place in their mouth.

When you’re trying to get your baby to latch or find a comfortable position to nurse, it’s challenging to think about anything else. It’s important to know that if it feels truly terrible, something is wrong.

Interestingly, the baby’s saliva can also irritate the areola and nipple. “While [breast] milk can be soothing [on the nipple], saliva from the baby is not great for the skin,” Wechsler says. “The saliva has enzymes in it. You know how some people lick their lips, and they get a line of red around their mouth? Saliva breaks down food. It’s really irritating to the skin.”

How To Heal Nipples That Are Bruised From Breastfeeding?

There are two main ways to heal cracked, bruised nipples from breastfeeding. First, fix the latch. Then, treat the skin issues.

Fix the Latch

Post-labor, one of the first calls I made from the hospital was to Kaznelson (who was my own lactation consultant). While the hospital did provide some lactation consultation support, I needed more one-on-one attention to get the latch right.

Kaznelson came to my home and assessed my nursing situation. She propped the baby up on a nursing pillow (specifically, My Breast Friend, which I highly recommend) and put lumbar support behind my lower back. Then, she showed me how to flip the nipple (a move she endearingly calls “the flipple”) deep into my baby’s mouth. Beforehand, my little lady’s latch was too shallow, causing much of my discomfort.

“Many times, we see the baby just on the nipple in the beginning,” she says. “We want to make sure this nipple is pretty far back in the baby’s mouth. You need to get to the junction between the hard and soft palettes. It should really be in this comfort zone.”

After this, with the right skincare treatment, the bruises should start to heal. “The fact that the baby is latching right is what’s helping it heal because you’re no longer creating that same problem,” Kaznelson advises. “If the baby continues to latch [incorrectly], you may keep bleeding. At least, that’s what happened to me and why I became a lactation consultant.”

Treat the Skin On the Nipples Topically

In addition to fixing the latch, it’s essential to care for the delicate skin around and on your nipples. Here are some ways I approached—and succeeded—in doing this.

The Salt Solution

The number one topical solution that healed my scabs and bruises, seemingly within hours, was using a mild salt-water solution on the skin. I first heard of this during my time in the hospital when one of the nurses gave me hospital-grade saltwater and some nursing pads. She advised me to soak the pads in the water and place them on my nipples.

Kaznelson has a better way to do it: she recommends pouring the saline solution into a shot glass and holding it on your nipples for one to two minutes. This gave my nipples a much more direct hit of the saltwater than the soaked pads. I used a medical solution (like this one), but you can also make your own. Kaznelson suggests starting with an eighth of a teaspoon of salt in 8 oz of water. Then, move up to a quarter of a teaspoon of salt before reaching the recommended amount: half a teaspoon. The idea is to build a tolerance.

“A lot of people say, ‘Salt?! That’s the last thing I want to put on my nipples,’” Kaznelson explains. “But, I tell them there is such a small concentration of salt that it feels soothing, nice, and healing. If it burns, then you’ve used too much salt. I prefer to start low and go up.” I felt no irritation from this method and got relief right away, but everyone is different, and you can always talk to your doctor if you have any concerns.

Using this salt hack helped me create a skincare routine for my nipples. After showering in the morning and evening, I’d soak my nipples in saline water for a minute. Then, I’d splash the area with a bit of warm water to rinse off any residual salt. “If you have any scabs or openings, it’s nice to let them air-dry for just a minute or so,” Kaznelson adds. I followed this up with a soothing nipple balm or ointment.

“We say to do it a few times a day, but if a mom has the time and the energy, she can do it more often,” Kaznelson notes. “I just don’t want moms to feel like they have to do it all the time because we have so little time.” Aim to treat your nipples around two to three times a day, if feasible.

Nipple Balms and Other Remedies

As with any skincare routine, before you apply anything, make sure your nipples are clean and dry. “It’s good to let your areolas and nipples really dry and then moisturize them,” Wechsler says. “Dry them [after nursing] with a soft cloth, and then moisturize them.”

Next, choose your remedy. If you don’t want to buy another item, go with the most natural option: your own breast milk. “I used to do that because the milk is soothing,” Wechsler shares. “You can let a bit of the milk dry on the surface of the skin.” She explains that it has healing properties because of the fat in whole milk (store-bought or mother-made).

Though I tried many organic and natural ointments, I found balms made with lanolin work best. “It’s just a great balm,” echoes Wechsler, who used the ingredient, herself. “It’s very emollient. You can heal under it. The lanolin creates a barrier against anything rubbing and protects the skin during the next feed.” I often applied lanolin balm before showering since even the hot water irritated my skin. That said, if you’re allergic to wool, steer clear, as lanolin is made from it.

You can also go to your kitchen cupboard to find a solution. “Any oil is good,” Wechsler notes. “Olive oil and saffron oil are the best because they have the highest concentration of linoleic acid in oils. That’s our skin’s natural moisturizer. I like to give back what the skin naturally makes.”

You can also try treatments like hydrogel nipple pads, which feel soothing—especially if you store them in the freezer. I applied cold gel pads to my nipples pre-feed to numb the area a bit. “Anything cooling is anti-inflammatory,” explains Wechsler. “The area is inflamed, and you want to cool it down.” She also recommends using ice packs or cold compresses.

What To Avoid

As with any skin sensitivity, avoid irritants. One example is wearing nipple pads. These are typically cloth pads that go over your nipple to protect it from your bra or soak up any milk leaks. “Sometimes they’re irritating,” says Wechsler. “Some people are allergic to them. You might think you’re doing something helpful, but it’s making it worse. Look at everything that’s touching your skin, and make sure it’s moisturizing.” The bottom line: treat the skin gently.

Should You Breastfeed Through the Pain?

Both experts agree: don’t breastfeed through intense pain. How do you know if it’s too much? “If a mom is in so much pain that she can’t even imagine feeding the baby again or she’s dreading it,” says Kaznelson. She suggests taking a break and giving the baby milk in another way, be it formula or via pumped breastmilk. I did all three: nursing, pumped milk, and formula.

“If someone’s nipples are cracked, bleeding, and in a lot of pain, they need to call their doctor,” adds Wechsler. “You could have mastitis, an infection, or something that needs treatment. A lot of mothers push through, only think about the baby, and ignore what’s going on.”

In doing so, Kaznelson adds that you can injure yourself to such a degree that you won’t be able to do it. “It’s not a badge of honor,” she says. “Take a break. Get advice. Women should not ‘just deal’ if it’s an unacceptable amount of pain.” To find a board-certified location consultant, visit International Lactation Consultant Association’s website.

According to Wechsler, your nipples should heal between two-weeks to two-months. “I know that’s a broad range, but for some women, it’s really bad for a long time,” she says. “And for others, it gets better quickly.”

It took me about two weeks once I fixed the latch and healed the skin. Then, it was smooth sailing for the first year of my daughter’s life…until she got teeth. But that’s a story for another day.

“Almost everyone can breastfeed in a comfortable way,” adds Wechsler. “The baby gets better at it. You get better at it. It’s a learning curve.”

Our Favorite Nursing Nipple Balms

Lanolin Nipple Cream for Breastfeeding
Lansinoh Lanolin Nipple Cream for Breastfeeding $8.00

Moms swear by this tried-and-true balm exclusively featuring lanolin. The thick balm features New Zealand-sourced lanolin and is free of fragrance, petroleum, parabens, and preservatives. It has a five-star review on Amazon with glowing comments about its effectiveness.

Organic Nipple Butter
Earth Mama Organic Nipple Butter $13.00

This botanical butter features organic ingredients, such as olive oil, ethically-sourced beeswax, calendula flower extract, and a concoction of butters (cocoa, mango, and shea). It feels soft and soothing on the skin.

Nipple + Lip Rescue Balm
Hatch Nipple + Lip Rescue Balm $28.00

Cool-girl maternity brand, Hatch, is responsible for this two-in-one product. It features a medley of nourishing butters, such as mango, pomegranate, and acai, and is free of parabens, phthalates, dyes, and fragrances. It’s also housed in chic BPA-free packaging. You can use it anywhere from lips to cuticles to nipples, making it a must-have to keep by your nursing chair.

Nursing Comfort Balm
Mustela Nursing Comfort Balm $15.00

Many know Mustela is a brand that offers luxe baby pampering products, but the French company also makes goods for mamas. This balm features nourishing olive oil and vitamin E while avoiding fragrance dyes, parabens, phthalates, and phenoxyethanol. Plus, it’s vegan.

Calm Your Nip Balm
Honest Calm Your Nip Balm $15.00

As you can expect from Honest, this balm is organic, unscented, and hypoallergenic. It offers a cocktail of trendy organic ingredients, including coconut oil, shea butter, aloe, and jojoba. It’s free of silicones, phthalates, and synthetic fragrances.