Pregnancy, New Moms & How To Cope With Engorged Breasts Plus Sore, Cracked Nipples
We all know in our heart of hearts that breast milk is best for babies, being perfectly suited to both nourish babies and protect them from illness as well as providing strong and early bonding between mother and baby.
The wonderful thing is that no baby is allergic to his mother’s milk although he can sometimes have a reaction to something his mother has eaten. Just a change in the diet can easily remedy that.
Although not insurmountable, there are two drawbacks to breast feeding
These are engorged breasts and sore or cracked nipples.
In some women, a few days after their baby is born, the milk supply comes on so quickly that the breasts become swollen, hard and even sore. There is an increased supply of blood and other fluids in the breasts as well as milk. The breasts and nipples may be so swollen that the baby finds it difficult to latch on and suckle. The discomfort can also make it difficult for mom to relax and enjoy feeding her baby.
The three most common causes of engorged breasts
- Breasts that are too full of milk
- Feeding in the wrong position
- Improper sucking by the baby
At the same time or shortly afterwards, a new mom’s nipples can become sore or cracked and this is painful and uncomfortable.
The main cause is similar to those second two reasons for engorged breasts - when the baby does not suck properly because of improper positioning of the baby at the breast. This can also cause severe nipple pain. You need to know that cracked and bleeding nipples are not a normal side effect of breastfeeding.
This natural method of feeding your baby is not meant to be painful.
Pain is a warning sign that you have a problem that needs correcting
Other reasons for sore or cracked nipples
- If your baby has thrush which is a yeast infection of the mouth.
- If you have severe dry skin or eczema. There is even an eczema-like condition which affects your nipples or breasts because of very dry air, a laundry detergent residue, certain ointments or lotions applied to the breast, some bath soaps or antibacterial cleansers, certain powders, hair sprays, deodorants or perfumes. So you need to be aware of these possibilities.
- The incorrect use of breast pumps which can hurt your nipples. Be careful if you use a pump as certain machines can injure delicate breast tissue, breaking the capillaries. In some women, excessive suction from a breast pump has caused haemorrhages under the skin.
You can rectify the problem of engorged breasts and/or sore, cracked nipples
- Avoid using plastic backed nursing pads, suction breast pumps or nipple shields.
- Never use soap or anything drying (such as methylated spirits) on your nipples and avoid scrubbing with rough towels or brushes. Just gently pat breasts and nipples dry with a soft towel or cloth after showering or bathing.
- Feed your baby on demand (this means with a new born every two to three hours even if it means waking your baby). Then feed your baby until he has had enough. Try to use just one breast per feed (alternating with each feed) so that the breast is completely emptied. If you find any breast lumps while feeding, gently massage these towards the nipple.
- Always wear a good, comfortable and well fitting bra which should not be under wired. Remove it completely when breast feeding, ensure it is not too tight and wear it at night.
- Before feeding your baby – make yourself comfortable and relaxed. Massage your breasts gently and apply warmth such as a shower or a warm wash cloth. Yu can express a little milk to soften the areola so as to get the milk flowing and to lubricate the nipples. If you need pain relief for the nipples or breast itself, apply a small ice pack. A small bag of frozen peas covered in a soft cloth makes a great ice pack!
- During your feeds, feed your baby from the least sore side first. Make sure your baby is properly positioned and attached to the breast. If the sucking hurts, then your baby is in the wrong position. Correct positioning is vital in allowing a damaged nipple to heal and to enable pain-free, effective breastfeeding.
There are different methods you can try:
1. Cradle position where the baby’s head is in the crook of your arm. Support your baby’s back and bottom with your arm and hand. Your baby will be lying sideways facing you. Your breast should be right in front of your baby’s face.
2. Football position where you tuck your baby under your arm like a football with his head resting on your hand. Support your baby’s body with your forearm.
3. Lying down position where you lie on your side with your baby facing you. Pillows can be used to prop up your head and shoulders.
4. If it is too painful to feed, then express by hand to keep the milk flowing and to keep up your milk supply while your nipples are healing. Feed the expressed milk to your baby and then start feeding again gradually with just short feeds spaced out during the day.
5. After feeds, check your nipples for any signs of stress. A cracked nipple may well benefit from applying a natural moisturizer as long as it has no additives. Let the nipple dry before covering again and ensure the nipples stay dry.
Once you have got your healing plans in place for either or both of these problem conditions, you will find that they will very quickly come right and you will be able to enjoy the breastfeeding sessions with your baby once more - to your mutual benefit.
Pustotina O. (2015). Management of mastitis and breast engorgement in breastfeeding women. DOI:
What to expect while breastfeeding. (2018).