10 Reasons and Ways to Manage Sore Nipples from Breastfeeding

Did you know that there are many reasons as to why your nipples could be sore because of breastfeeding? The most common reason is how your baby latches onto you but continue reading to find out other possible reasons and when to get professional help.

What causes sore nipples while breastfeeding?

There are four main reasons why you can have sore nipples while breastfeeding. They are:

  • a baby not latching well
  • chafing
  • thrush
  • adapting to this new skill

Prevention is definitely possible, and the treatment will depend on what the cause is. It is also possible to have a combination of reasons.  

1.Check the Latch

The first step is to check the latch. This is the easiest of the sore nipple “problems” to fix. Breastfeeding can take time to learn and you may need to get a lot of practice. Checking your technique so that you are comfortable. Many babies and mothers need to practice getting the right latch. A healthy and comfortable breastfeeding latch is deep in the breast and helps to get most of your milk out while preventing pain.

There are many ways that a baby may have difficulty in latching. The most common problem is the shallow latch. Your baby’s lips should be around the dark area of your breast (not just your nipple). When your baby has a shallow latch, your nipple has pressure from the top of your baby’s hard pallet and the suction is very focused onto your nipple. A shallow latch can even cause bruising on your nipples.

Tips for a good latch:

  • Tickle baby’s upper lip with your nipple and wait until their mouth is wide open (like a yawn) before you gently guide them to the breast. Wait for your baby to open her mouth wide. If she does not open wide you will get a shallow latch
  • Pull them off and start over again if they don’t latch well at first. Use your pinky finger to break the seal. Place your pinky in the side of your baby’s mouth and gently pull your baby off. This helps to prevent your baby from biting down which stops the suction on your nipple.
  • If you deliver at the hospital, ask nurses to check your baby’s latch throughout your hospital stay. If you delivered at home, ask your midwife or doula for guidance.
  • You can use a nipple shield temporarily and under the guidance of a lactation consultant.

If you continue to have trouble, pain, or your baby seems frustrated while nursing, contact a lactation consultant. A licensed consultant can give personalized help. You can find a list of registered lactation consultants

2. Treat tongue tie, if needed

Persistently sore nipples can occur if your baby has a tongue-tie. If you are concerned that your baby has a tongue-tie, ask your lactation consultant for an assessment and referral to a Doctor who cuts tongue ties

3. Adjust your hold

If you are sitting comfortably while feeding this will help you and your baby to have comfortable breastfeeding. There are many different breastfeeding positions. There are also many videos on U-Tube that you can watch.  

The main tips are:

  • tummy to tummy so that your baby faces your breast. It is difficult to swallow if your head is turned at 90 degrees from forward.
  • Keep your baby’s ear, shoulder and hips in a straight line. This will help to keep your baby facing forward.
  • Use pillows, blankets or a footstool to help you feel comfortable.

4. Reduce Engorgement

Engorgement is when your breast feels full and even hard. Engorgement happens if you go too long between nursing, or if you’re still in the early stages and your supply is adjusting to the baby’s needs.

Engorged breasts may hurt. If your breasts are too hard it may prevent your baby from being able to latch on. You may need to release/ express a little bit of milk before you latch your baby on.

You can express a little milk to help soften your breast.

5. Thrush

Your nipples are often wet because of repeated breastfeeding. If your nipples are constantly or often wet this can result in thrush. Unfortunately, thrush is very contagious and can be passed on to your baby very easily. Thus if either of you has thrush both of you need to be treated for it by a doctor. If you are concerned that you may have thrush lookout for your nipple becoming pink, shiny and hurting. You may also feel a sharp shooting pain while breastfeeding.

To prevent thrush, dry your nipples between feeds. You can blow on or pat your nipple with a baby towel to dry, or you can walk around topless to air dry. Wash your nipples as per normal with a mild soap when you bath. Dry them properly after your bath. The use of disposable Breast pads are useful to help keep your nipple dry.

6. Moisturize your nipples

It is important to keep your nipples clean and dry but they also need to stay moisturized. They can be sensitive and crack and bleed during breastfeeding if they become too dry.

You can use Lanolin nipple creams. Before you decide to use a cream on your nipples make sure that it is safe for your baby as your baby will also take in the cream. Read product labels and ask your doctor which creams they recommend.

When using a nipple cream, clean the area with water then apply the cream straight after you have fed. This gives your nipples enough time to absorb it.

7. Choose the right size breast pump flange

If you are using a breast pump it is important that it fits you correctly and is comfortable. Using the wrong sized breast flange can cause your nipples to become irritated and sore. It can also affect the amount of milk you express when pumping.

You may need to change sizes as your breasts change over time, too. Always check that you have the correct size flange. Also, be sure to use a vacuum strength and speed that feels comfortable for you while pumping. Making the pump too strong will not result in more milk, but may hurt you.

8. Apply cool compress

Cool compresses/hydrogel pad can help soothe sore nipples after breastfeeding by reducing swelling. You can use a cool compress on your breast and nipple as well as under your arm.

Apply the compress a few minutes at a time. You can do this on and off for a few hours until the swelling is reduced.

A Hydrogel pad can help to soothe sore nipples. You can use them at room temperature or place them in the fridge. The pads also help to prevent your nipples from sticking to your bra or chafing on fabric.

9. Check for and treat Milk Blebs

milk bleb is a blocked nipple pore. It appears as a small white or yellow blister on the nipple. A milk blister may go away on its own or it may recur.

You can try massaging it with olive oil. This helps to soften your skin. If you pick it, it may cause bleeding and infection. You can also try applying a warm compress and then hand expressing some milk to see if that releases the block.

Talk to your doctor if you have a painful, recurring blister.

10. Wear a supportive bra

Choose a bra that’s breathable to prevent chafing. If it’s hard to find a bra that fits consistently while you adjust to milk supply and breast size, look for nursing camisole tops that tend to have more stretch. Any restrictive clothing may cause pressure on your breast and cause you to have a blocked duct that can cause engorgement or mastitis.

Ask for help if you need it.

Nipple pain is common among breastfeeding women in the first few days. However, if the pain gets worse or does not resolve don’t wait too long for help. Your lactation consultant would be your first stop for assistance.

Reaching full milk supply:

Using a breast pump

When both my babies were born I was not able to hold them let alone breast feed them. Breastfeeding was my goal and I had decided that formula was not an option. I knew of the extra risks formula can be to a prem baby and that is why I decided I would do my best to avoid formula.

Even though my babies were born early at 32 and 33 weeks, I knew that my body would be able to make enough breast milk for them. In fact because they were prem my milk was a better match for their nutritional requirements than full term breast milk. Did you know that mothers start to make colostrum (first milk) in the second trimester? As soon are your baby is born your hormones change and you are able to make more milk.

If your baby is unable to breast feed after birth (there could be a number of reasons), pumping is the next best way to establish your full milk supply

My first born was an emergency that I was not prepared for, while with my second baby, I had 3 weeks to prepare. The most important thing that you can do once your baby is born is start to stimulate your breasts. With the first baby, I did not even have PJ’s never mind a breast pump so, my husband and I manually expressed and used a (needleless) syringe to suck up each and every precious drop of breast milk. The syringe was sent to my baby in NICU. With number two I had a few weeks to plan. I had ordered a hospital grade breast pump and it was ready the day before I had my c-section. From experience I knew that there may be a delay after the birth or I might not feel up to expressing (due to meds) so the night before and the morning of my daughter’s birth, my husband and I manually expresses 9 ml of colostrum for her. This really settled me as I knew that she would have enough milk until I could get my pumping and expressing going.

The first few days were filled with many emotions: worry about the little ones in NICU, excitement as each piece of medical equipment was removed from my very little one, sadness that I went home without them, fear that I would not be able to make enough milk and exhaustion from the driving up and down, pumping and splitting myself between my family and my baby. However we all got though, we managed somehow and with all the pumping and storing of milk I got my supply up to be able to feed my babies for as long as we needed. This long term adequacy of milk supply I put down to the fact that we got the first day and few weeks right with regards to expressing and stimulating the milk production.

Golden tip: Do not wait to express.

Research shows that it is best to stimulate your breast within 1 hour of birth. You can manually express or use a hospital grade breast pump.  Make sure that you have started to express within the first 6 hours.

Golden tip: Pump 8 to 10 times in 24 hours

You need to imitate how often your baby would be feeding as if she was drinking directly from you. This translates to about a 3 hourly pump schedule, if you want to have a bit of a longer sleep you can but try not to go longer than a 5 hour stretch without pumping.

Golden tip: Save time and double pump.

Double pumping helps you to save time as you are emptying both breast at the same time. By double pumping you are more likely to reach your full production sooner.

Golden tip: The more you pump the more you make

Keep a log to help you keep track of how you are progressing. By 2 weeks old you should be at full milk production of about 750-1050ml of milk in 24 hours. If you drop a pump session expect your milk output to be reduced.

Golden tip: Establish full milk supply as soon as possible.

Your baby may not need as much milk as you are expressing but you are setting yourself up for success.  The Elite hospital Grade Breast pump has research studies that has proven that it can help mothers to reach their full production within 7 to 10 days of exclusive pumping. The more you breastfeed or express the more prolactin you make. This is a hormone that helps you to make milk.

Golden tip: You should not be pumping for long periods of time

In Days 1 to 3: Pump at least 10 -15 minutes for each pumping session. You can also hand express in to your flange after you have pumped. Remember in the first few day to only expect a few drops of colostrum but save every drop for your baby as they are all important.

After day 4: Once your milk is in, pump for about 15-30 minutes per session. Continue to pump for 1-2 minutes after the last drop. This helps you to increase the prolactin so that you can make more milk at the next feed.

Golden tip: Prepare yourself for expressing

There are ways that you can get your breasts ready for expressing. You can use heat from a bean bag, hot-water bottle or a baby bottle to gently message your breasts. Use circular motions from the base of your breast and move toward your nipple. You can use your knuckles in a rolling motion from the base towards your nipples. And your finger with gentle tapping rhythm. For more tips click here  

If you find yourself needing assistance due to your baby being in NICU and need to pump consider as hiring a hospital grade breast pump. They do help to make your life easier and your pumping session more productive. Find help from a lactation consultant who can guide you and help you with little tips that make your journey so much easier. It is never easy to have a different birth than what you planned, take some time to look after yourself and realize it is better to ask for help than to battle alone and not get the experience that you want.

Breast feeding & Work Balance

AMeda breast pumps supports working moms

by Carey Haupt RD(SA) SACLC

Breastfeeding and work is a delicate balance, with a bit of practice it can be done. So you don’t need to stop breast feeding just be prepared. Being away for your baby does not mean that you can’t keep your supply up and continue to breastfeed. Did you know that under South Africa Law you are entitled to two 30-minute breast feeding breaks in the first 6 months of your baby’s life? These breastfeeding breaks are paid for time. The law that allows for these breast-feeding breaks is called the Code of Good Practice on the Protection of Employees during pregnancy and after birth of a child.

Unfortunately, some companies may not have the correct policies in place to support the code. In order to benefit the most from this law approach your HR manager while you are pregnant and inform them that you are intending to continue to breastfeed when you return to work and would like to have the facilities available so that you can safely express your breast milk. This allows the company the additional time to find a space that is suitable for you and to amend any policies if needed. If your HR manager is not aware of the Code of good practice you can down load it here.

A main concern for some moms is that their milk supply will run dry or that they will not be able to make enough milk for their baby once they return to work. Luckily breast milk is made continually over a 24-hour period and your body adapts to your cycle of milk production. Your two 30-minute breast feeding breaks can be used to support this cycle and to supply milk for your baby while she is away from you. Most moms can express a full feed in 15-20 minutes. The additional time can be used for preparing to express and cleaning up afterwards.

There are a few ways in which you can use your breastfeeding breaks, discuss the different options with your HR and see which one best suit you:

  • Use the two breast feeding breaks during the day. One in the morning and one in the afternoon to express milk while you work.
  • Combine the breaks and have a longer 1-hour breastfeeding/ expressing session. This can be useful if your child is close to your work so that you can direct feed.
  • Use the 60-minutes to shorten your work day and direct feed your baby at home/ creche before or after work

In the Code of Good Practice, it says that “where possible provision should be made for the establishment of facilities for breastfeeding under adequate hygienic conditions at or near the work place”. This in common terms means that your employer should provide you with a clean space where you are able to sit down in, that gives you privacy and access to clean water and secure storage for your breast milk. Some employers are very accommodating and can provide fridges and microwaves with a special allocated room while other employers are not able to. What the code protects you from is the use of a toilet to express or breastfeed you baby in and having to express in front of other work collages.

How to practically keep your milk supply up for your baby.

Step 1: Build a stash

You only really need to start to store up a supply of breast milk about 2 weeks before you go back to work. Some moms start very early with collecting milk and that can cause them to have to buy a new freezer, which should not be necessary.

How much milk to expect when expressing:

If you are expressing in between feeds while direct feeding expect to express about half a feed.
If you are expressing to replace a direct feed expect to express a full feed
Women have different storage capacities so some women will be able to express more than what is expected. All women are different and try not to compare yourself with others.

Step 2: Find your work expression spot

As discussed earlier you are entitled to a safe clean space where you can sit and express your breast milk. Make it as comfortable as possible for you. If you need a pillow to make the chair more comfortable bring one from home. Check to see if you can lock the door, or bring a sign for the door that indicates that you are expressing and that you should not be disturbed

Step 3: Make the place clean and hygienic as possible

If needed clean the surfaces. Wash your hands before your start expressing. Bring sterilized equipment to the office. This way you can avoid the need to sterilise at work. If you sterilize your equipment at home, you can bring it to work in a clean container like a Tupperware or Ziplock bag. If you have access to a microwave at work and you would like to sterilize your equipment use a closed container or a microwave sterilization bag so that you can keep your equipment clean. Work microwaves might not be cleaned as regularly as needed.

Step 4: Prepare for expressing

Use a few minutes to disconnect from the hustle and stress of work. Focus on your baby, you can even watch a short video or look at pictures of your child. You can use heat pads and/or massage your breast to help with the let-down.

Step 5: Express your milk

Every mom should know how to hand express. This can be very important if you forget a pump part at home. A double electric breast pump is most often the fasted ways to express breast milk.

Step 6: Store your milk safely

Once you have finished, store your breast milk into the contain that you will be freezing it in. Make sure it is closed tightly and will not leak during transportation. Depending on the facilities that you have at your workplace. You can store your milk in a fridge or cooler bag with ice packs for the rest of the day. Once you are home you can freeze or get the milk ready for the next day.

It is important to take into consideration the different cultures at work. Some people may find it offensive to keep expressed breast milk in the fridge (we hope that that will change soon). If this is the case, you can keep you bottle of milk in a non-see though container and your work colleague most likely will not even know it is there. Remember to label the bottle with baby’s name and date of expression so that you can identify your milk and how old it is.

Step 7: Clean up

Make sure that you leave the area clean and ready for the next mom to use.

If you are going to express again later in the day, you can either wash and sterilise your flange (not always possible) or you can store the flanges as they are (used) in a clean container and use them again later at the next breastfeeding break. The breast milk should not spoil in this time and if possible, you should keep the flanges cool in a cooler bag or the fridge.

It is always idea to wash and sterilise your breast pump equipment after every expression session, however this is not always possible. Try to wash and sterilize your breast pump equipment at least once a day when you get home. That way you know that you are starting out with sterilized equipment and you can control where it is kept during the day.

Step 8: Prepare for the next day

Once you are home wash and sterilise your equipment. Once your equipment is dry pack it away ready for you to take to work. This way you are less likely to forget it in the morning.

Step 9: Decide how you will feed the expressed milk to your baby

There are different ways to feed the breast milk to your baby. The World Health Organisation recommends cup feeding. However, many mothers find that bottles are more culturally accepted. If you do decide to use a bottle consider using PACE feeding method, which allows for the baby to show you when they are full, protects their airway form choking and can also prevent overfeeding.

How to Start using a breast pump

Once you have your breast pump it will be time to start pumping. Here are some easy tips to follow to help you getting started:

  1. Read the manual
  2. Hygiene first
  3. Get comfortable
  4. Assemble your Ameda® HygieniKit
  5. Select the best pump settings
  6. Hands on pumping
  7. Increase milk expression
  8. How long to pump for?
  9. Should expressing hurt?

Read the manual

Learn how our pump works. find out how to use the adaptor and batteries, where to connect your Ameda® HygieniKit in. How to assemble your
Ameda® HygieniKit correctly and how to look after your flange parts.

Hygiene first

Ameda breast pumps are all about pumping the safest breast milk for your baby. That is why all of the Ameda pumps are closed system pumps. Please sterilise your Ameda® HygieniKit before use. you can use the sterilization method that is most easy for you: Steam sterilization, boiling or using a sterilizing fluid.

Wash your hands. Remember to wash your hands before you start expressing. you hands will touch the value and inside of the bottle and thus need to be as clean as possible.

Get comfortable

Find a place where you are comfortable to pump. Many mothers like a quiet comfortable chair were they can focus on their baby while pumping. Have something to drink or snack on ready just in case you might need it.

Assemble your Ameda® HygieniKit

Now that your Ameda® HygieniKit is sterilised and your hand are clean, assemble your Ameda® HygieniKit . Make sure that the value is pushed on correctly and that your flange is connected tightly. You are now read to centre your flange over your nipple/s and make an air seal.

Select the best pump settings

When using a breast pump you need to copy how a baby would drink. When a baby latches on to a breast, she will suck quickly until milk is flowing in her mouth. It takes a minute or two for the milk to start flowing. When the milk is flowing, her sucks slow down. When the milk flow slows, she will suck fast again to start another milk ejection reflex or let-down.

Did you know that most mothers have an average of four milk ejection reflexes during a breastfeeding session?

So, when you start pumping, have the suction at your highest comfortable level and turn the speed up all the way. Be patient, just like with breastfeeding, it can take a minute or two for the milk to start flowing.
Once, your milk starts to flow, turn the speed down to allow long, sprays of milk to come out of your breasts. When the milk flow starts to slow or drip, turn the speed back up. This increase in speed helps your body let-down more milk or have a milk ejection reflex. Once, the milk starts to flow again, turn the speed down. Repeat this until you are no longer able
to get milk flow and your breasts feel well drained.

Hands on pumping

Hands on pumping can help you get more milk while using your Ameda breast pump. Why is it effective?

During breastfeeding, your baby’s warm, little hands naturally rest on your breasts massaging and stimulating hormones to help your milk
flow and production. You can help mimic your baby by using hands-on pumping techniques while pumping to help drain your breasts better.

How to do hands on pumping:
• Gently massage your breasts with the pads of your fingers. Use circular motions.
• Gentle, low heat applied to your breasts has been shown to increase time to milk flow.
• Gentle massage as described above to help drain the alveoli where the milk is stored.
• Compressing your breasts gently with your hand in a C-shape while milk is flowing can help drain your breasts better.

Increased milk expression

You can use your mind and senses to help you to pump more breast milk. Try the following to increase your milk expression:

Mind: Close your eyes, relax and imagine your baby breastfeeding, a waterfall or something else that relaxes you.
Sight: Look at your baby or a photo of your baby. Some moms prefer looking at a magazine or reading a book.
Hearing: Listen to a recording of your baby cooing. If you are apart, call and check on your baby. Or, listen to your favorite relaxing music.
Smell: Lie your baby’s blanket or clothing on your shoulder to take in your baby’s sweet smells while pumping.

How long to pump for? 

Not everyone drains their breasts in the same amount of time. On average, it takes 10-15 minutes if double pumping. If you find it takes longer try some of the suggestions above, check that your Ameda® HygieniKit is assembled and connect correctly to your pump and check your flange size.

Should expressing hurt?

No, it should not hurt you when you pump. If it does hurt please stop and assess the following:

The suction level. The strongest pump suction does not always pump more milk. You should feel a tugging when you pump, not pain. If you feel pain,
your body tenses up and it is harder to release milk. Always, turn the suction level to your highest, comfortable level.
The breast flange fit. If your flange is too small or too large, it can hurt to pump. Your milk may not flow as well if you have the wrong flange fit.

Tips on how to choose a breast pump

If you are wanting to breastfeed your baby you most likely have thought about getting yourself a breast pump. There are so many different types to choose from. Let us help you choose a breast pump that is best for you. At first the idea may be simple but there are quite a few different types of pumps. The Elite is a hospital grade pump that can be used by different users. Then there are the personal use pumps: The lactaline which is a double electric, the Una which is a single electric and the manual. There is the perfect pump for you and to help you make sure you chose the correct Ameda pump for your needs, follow these 6 easy tips:

Rental or personal

There is a difference between a hospital grade and personal grade pump. The Hospital grade and personal pumps use a different mechanism to help create the negative pressure that draws out your breast milk. The Elite hospital grade pumps are mainly for mothers who have to establish their milk supply without the assistance of their baby. This would be a mom who has her baby in NICU, a mom who is adopting and wanting to breastfeed or a mom who has returned to work and needs to pump effectively and fast. If you are planning on only using a pump for a short period of time, the rental option maybe the most cost effective. To learn more about our rental program click here

The Ameda personal pumps are much smaller in size than the hospital grade pumps which makes them portable. Our electric pumps use both mains electricity and batteries which make them portal and ideal for taking to work to pump. They even have a car adaptor which makes it possible to pump while in the car. The Ameda Manual pump allows for multiphase pumping and is easy to transport.

Closed system or open system

Closed and open systems refer to the ability of moisture, air or breastmilk to move through your pump and collect in your tubing or pump motor. With open system pumps, moisture or breast milk is allowed to collect in the tubing or motor which can allow for the growth of bacteria, viruses or moulds. Studies have found: Klebsiella, Staph. Aureus, Str. Faecalis Ser. Marcescens and Ps. Aeruginosa and Pseudomonas aeruginosa in the tubing, flange sets, expressed breast milk and motors of open system pumps.  This can be very dangerous for sick or premature or sick infants and the bacteria or virus can be transferred to your baby via contaminated breast milk. It is very difficult to clean out the tube and sterilise the tube or the pump once it has the milk in it. If you see breast milk or moisture collecting inside your tubes it is best to replace the tubing. To keep replace tubing can be time consuming and expensive.

A safer option is to use a pump that has a complete closed system. All Ameda breast pumps are closed system. The Ameda FDA approved design has a silicone diaphragm that does not allow for the movement of air or moisture to pass from the flange into the tubing. The placement of the barrier is very important because the studies found that the contamination of the tubing was within the first 4cm form the flange. This makes it so important that the barrier should be between the flange and the tubing. This means that the moisture or milk is not able to move into the tube or the motor. This results in you not needing to clean, sterilise or replace the tubing parts.

Used or new pump 

There are a lot of mothers looking at purchasing second hand pumps online or borrowing a pump from a friend. The reason for this is that electrical pumps can be very expensive. Although you would be saving some money there are risks involved with purchasing a second had pump. As mentioned above there are very real risks of purchasing an open system pump. With a second hand pump the risk for mould, viruses and bacteria being in the actual motor of the pump is much higher. Studies showed that although most of the contamination happened within the first 4cm of the tubing with usage the risk of the contaminates traveling though the tubing and up in to the actual motor was greater. It is always recommended to buy a new pump rather than a second hand one. If you can’t not afford a new electric pump consider a manual pump, a closed system pump and at least to buy your own flange and tubing sets (which will add to the price of the pump).  

The decision between a manual and an electric pump can be based on two main factors; Price and usage.  As mentioned before, electric pumps are more expensive than manual pumps.  Some mothers respond really well to manual pumps and find them easier to use compared to electrical pumps. Electrical pumps are mainly used by mothers who go back to work because they make pumping quick and effective.

Double or single

The lactaline double pump has two flanges so that you can pump both breasts at the same time. This helps to half the amount of time per pump session. Also, double pumping results in your breasts producing more milk per pump session. The Una single pump are less expensive than double pumps and can be a very useful option. They are idea for a mom that has a bit more time to pump for her baby.

Comfort and fit

With the Ameda range of breast pumps you can make sure that you chose a pump that is comfortable and fits you well. If you are comfortable while you express, you will also produce more milk. Once you have decided which type of pump would be the best for you, make sure that the brand that you chose will fit you perfectly and be comfortable while you pump. Ameda has a range of flange sizes because not all breasts are the same size. If the flange is too small it can hurt your nipple and if it is too big it can result in poor expression of breast milk. If you are not sure of your flange size you are welcome to contact us and we will help you chose your correct size.