Why Breastfeeding Hurts: Understanding Sore Nipples and What Can Help

Breastfeeding isn’t meant to hurt. Some sensitivity in the early days can be normal, but ongoing pain, sharp discomfort or nipples that look damaged are a sign that something needs attention. You deserve to feel comfortable, supported and confident at the breast.

This guide looks at the common reasons nipples become sore, how to tell what might be going on, and what can help. If you’d like more detail on improving positioning or latch, you can read our companion post Positioning & Attachment: Latching.

A little tenderness… or something more?

During the first week or two, some parents notice:

• brief tenderness at the start of feeds

• a sore, sunburn-like feeling

• nipples that look the same before and after a feed

This usually settles quite quickly.

Pain is worth exploring if:

• it continues throughout the whole feed

• it’s present between feeds

• the nipple looks squashed, creased or misshapen afterwards

• there are cracks, bleeding, blisters or scabs

• you find yourself dreading feeds

Pain is a signal, not a failure.

Shallow attachment (the most common cause)

The most frequent cause of nipple pain is that baby doesn’t have enough breast tissue in their mouth. Even when the latch looks okay from the outside, the nipple may still be sitting too far forward inside baby’s mouth.

Common signs include:

• pain that continues until baby comes off

• a slanted or “lipstick-shaped” nipple afterwards

• a pale stripe across the nipple tip

• rubbing, chafing or small cracks

  
  

What helps:

• letting baby’s chin lead as they come to the breast

• keeping baby's head free to tilt back

• holding baby close so their body stays aligned

• waiting for a wide, open mouth before bringing baby in

• trying laid-back or side-lying positions for more space

• re-latching if things feel uncomfortable or baby slips down the nipple

If you’d like step-by-step help, see our blog on Positioning & Attachment. https://www.breastfeedingsupportnorwich.com/post/positioning-attachment-latching

Breasts feeling very full

Around days 3–5, or if feeds haven’t been frequent, breasts may feel swollen or firm. This can flatten the nipple and make it harder for baby to latch deeply.

You may notice:

• heat, fullness or tightness

• baby struggling to get a mouthful of breast

• soreness after several attempts to latch

  
  

What helps:

• frequent feeding

• using gentle pressure around the base of the nipple for a minute before feeds known as Reverse Pressure Softening can help baby latch

• a cool compress between feeds if breasts feel hot and swollen

• warmth or a short massage before latching if it helps your let-down

https://www.breastfeedingsupportnorwich.com/post/the-mastitis-spectrum-what-you-need-to-know

Your nipple or breast shape

Nipples vary widely. Flat, inverted, long, short or large nipples are all normal and can all breastfeed well, but some combinations of baby-mouth and nipple-shape can be more sensitive in the early weeks.

Things that may help:

• adjusting positions to work with your body

• shaping the breast gently as baby latches

• allowing baby to come from underneath (chin-first)

• occasionally, short-term nipple shields with skilled support

  
  

If pain continues even when the latch looks good, a breastfeeding specialist can help review what’s happening inside baby’s mouth.

Variations in baby’s mouth or sucking pattern

Sometimes pain is related to baby’s oral anatomy or how they use their muscles when feeding.

Possible signs:

• clicking sounds

• slipping off repeatedly

• prolonged feeds with nipples looking pinched

• difficulty keeping breast tissue deep in the mouth

This might be due to:

• a small mouth (especially in early weeks)

• a receding chin

• jaw or neck tension

• restricted tongue movement or suspected tongue-tie

Support with positioning often helps a great deal, but some babies need a fuller assessment of sucking function. https://www.tongue-tie.org.uk/information

Pumping and nipple irritation

Pumping should not be painful. If it is, look at:

• flange size

• nipple rubbing the sides of the tunnel

• too much areola being drawn inside

• suction set too high

• 
  

Nipple size can vary from side to side, and it’s normal to need different flange sizes for each breast. Small adjustments often make pumping much more comfortable.

Sudden sharp, burning or stabbing pain (vasospasm)

Some people experience a sharp, burning or stabbing pain during or after feeds, sometimes with the nipple turning white. This is called vasospasm.

It can be triggered by:

• a shallow latch

• cold exposure

• Raynaud’s phenomenon

• stress

  
  

What may help:

• improving depth of attachment

• keeping nipples warm right after feeds

• avoiding sudden temperature changes

• speaking with your GP if Raynaud’s is suspected

Skin irritation

Sometimes soreness is caused by the skin itself being irritated rather than by breastfeeding mechanics.

Possible triggers:

• reactions to nipple creams

• fragranced detergents or toiletries

• moisture trapped against the skin

• eczema or psoriasis

Changing products, letting the area air-dry when possible, and using treatments recommended by your GP can help.

Milk blisters (blebs)

A milk blister appears as a tiny white or yellow spot on the nipple. Some are painless; others can be quite sore.

They’re considered part of the “mastitis spectrum” see our blog here https://www.breastfeedingsupportnorwich.com/post/the-mastitis-spectrum-what-you-need-to-know, linked with local inflammation rather than simple blockage.

What helps:

• gentle, comfortable feeding

• warm compresses if soothing

• getting support if pain is sharp or ongoing

  
  

Possible infection

If the nipple is cracked or damaged, bacteria can sometimes enter the skin.

Signs include:

• persistent pain

• yellow discharge or crusting

• swelling, redness or warmth

• wounds not improving

Washing damaged nipples once a day with mild soap or saline solution can help reduce bacteria on the surface. A GP can advise on whether antibiotics are needed.

Supporting healing while you sort the cause

While you’re working out what’s behind the pain, you can try:

• starting feeds on the less sore side (you may prefer to get it over with)

• switching positions to change where the nipple is pressed

• expressing a little milk onto the nipple after feeds

• using a small amount of purified lanolin, petroleum jelly or coconut oil if tolerated

• hydrogel pads (avoid these if infection is suspected)

• changing damp breast pads promptly

  
  

If feeding directly is too painful for now, expressing and feeding milk another way is a perfectly valid short-term plan. Babies do not lose the ability to latch.

When to reach out

Please get support if:

• you’re in pain

• you’re unsure what’s happening

• your nipples are damaged

• the pain isn’t improving

• you suspect tongue-tie

• you’re feeling distressed or worried

  
  

.Short-lived tenderness usually eases within about the first week but ongoing or worsening pain is a reason to get support, You don’t have to figure this out alone.

Marion Frey-AlQurashi Breastfeeding Counsellor & Mindful Breastfeeding Practitioner