Patient Portal

Quincy Office
(617) 773-5070

Marshfield Office
(781) 837-5070

Breast Feeding

Nipples, Sore

This article is an excerpt from "The Nursing Mother's Problem Solver" by Claire Martin.

Some mothers have sore nipples, even if their babies seem (to an untrained eye) to be properly latched on, with textbook-style suckling. Pain always indicates a problem that needs to be diagnosed and resolved. Breastfeeding is not normally a painful experience. With some detective work, you may be able to isolate the source of your pain and remedy the problem.

If you've had pain nursing right off the bat-nipple pain that hasn't lessened since your first nursing session-there may be a problem with positioning, latch-on, or your baby's suck. It also is possible that the problem is physical. Ask the pediatrician and/or your lactation consultant to examine your baby's mouth. She may have a high palate, or a short or tight frenulum (the tissue under the tongue) that makes it difficult for her to use her tongue.

If breastfeeding already is established, and your nipples are suddenly sore, you may have thrush. To properly diagnose thrush, both you and the baby should be examined by a lactation consultant and then by your physician. Sometimes, even if you've taken medication for thrush-lotrimin, loprox, nystatin-the thrush may still be present if you and the baby haven't been treated simultaneously for at least 2 weeks. Thrush is persistent, and it can be resistant to drugs, returning after you think that you've treated it. If you do have thrush, do not treat your nipples with hydrocortisone; it only makes your nipples even more sore.

If your nipples are red and sore, but thrush has been ruled out, another possibility is eczema of the nipples. This occurs in women with a history of eczema and dry, sensitive skin, and it usually is accompanied by burning and itching.

Sore, tender nipples also can signal pregnancy, especially if you're also exceptionally tired and nauseated. Could you have a breast inflammation or infection? Did you have mastitis? Even if you treat mastitis with penicillin, the drug may not have resolved the staph infection. If your pain is caused by a persistent staph infection, ask us about dicloxacillin, which must be taken conscientiously for 2 weeks.

Could you have a bacterial infection in your nipples? Are they cracked and refusing to heal? Those infections are painful and can lead to a bout with thrush. (See Thrush).

If you've eliminated infections, inflammation, thrush, and positioning as the culprits, you should see a dermatologist familiar with breastfeeding-related problems. (Your lactation consultant, or the local La Leche League, should be able to suggest someone.)

Tips for preventing or healing sore nipples:

  • Check the baby's position when she latches on. Make sure the nipple is pointing at the back of her mouth and that she's encompassing as much of the nipple and areola in her mouth as possible.
  • Make sure the baby's lower lip is flanged, not sucked into her mouth. Pull down his lower lip. You should be able to see his tongue between his lower lip and your nipple.
  • Use warm compresses and expressing a little milk to soften nipples hardened by engorgement.
  • Use your finger to break the baby's latch suction, rather than pulling the baby off your breast.

About the Author

Claire Martin is a parenting writer at the Denver Post. Her writing has won national and regional awards, and has appeared in publications such as the St. Petersburg Times, Good Housekeeping, and Sunset magazine. She lives in Denver with her husband and two daughters, both of whom were breastfed.

From THE NURSING MOTHER'S PROBLEM SOLVER by Claire Martin. Copyright © 2000 by Claire Martin. Reprinted by permission of Simon & Schuster, Inc.

Is Your Child Sick?TM

Visual Symptom Checker What's Going Around

News @ QPA

  • 2019 Flu Clinic Dates!

    Flu Vaccine has arrived! We will be having a few flu clinics for our existing patients.   Call the office today to schedule your child's annual flu vaccine. Below are the dates of our  current Flu Clinics.  We will be adding more clinic dates in a couple weeks.  Call the office if you would like to bring your child in for one of our clinics.
    • Saturday, 9/14 in Quincy, 9am-1pm
    • Tuesday, 9/24 in MARSHFIELD, 5pm-7pm
    • Saturday, 10/12 in Quincy, 9am-1pm
    • Tuesday, 10/22 in Quincy, 4pm-7pm
    • Saturday,10/26 in MARSHFIELD, 9am-1pm
    • Saturday, 10/26 in Quincy, 1pm-4pm
    • Saturday, 11/9 in MARSHFIELD, 9am-1pm


  • Remembering Dr. Russell Irons

    To All our Quincy Pediatrics Families, Friends, Patients and Colleagues,
    It is with great sadness that we announce the passing of Dr. Russell Irons, January 3, 1927-July 28, 2019.  Dr. Russell Irons touched the lives of so many people as a beloved physician, father, grandfather, friend, and colleague.  Dr. Irons started Quincy Pediatrics in 1971 and provided exceptional care to his patients for over forty-five years.   Dr. Irons will be remembered for his compassion, sharp intellect, contagious laugh, and love for his family, friends, colleagues, patients, and Becket/Chimney Corners family.   The love and gratitude we all feel for him cannot be expressed in words.   The legacy of Dr. Russell Irons will live on in the hearts of all who knew and loved him.