Nipple Pain -- Ouch!!
Unfortunately, many parents experience nipple discomfort.
It’s not that breastfeeding causes this pain but other things can like a latch which isn’t deep enough, infant conditions like tongue tie, pumping (too much, wrong size flange…), or even some ointments and balms.
The best nipple ointments for soothing the skin or for use as a pumping lubricant don’t contain lanolin, coconut oil, or petroleum products. Try an organic product like Earth Mama, Bamboobies, or Motherlove. Other ingredients may cause an allergic reaction or irritation (dermatitis). There is a prescription ointment called APNO (All Purpose Nipple Ointment) which should be used only as indicated as it’s an anti-bacterial, anti-fungal, and steroidal compound. Nipple pain is very rarely caused by fungus/yeast but anti-fungal medications can actually increase pain.
Care for the nipple like any other skin on your body… Wash once per day with mild, scent free soap. Keep the skin clean and dry.
If there is tissue damage: Lubricate with a moisturizing balm (see above) or try Medi-honey (irradiated, medical grade honey and many nipple wounds respond well to treatment).
Hydrogel pads (changed daily) protect the wound from irritation and keeps the site clean. You can use this with your nipple balm. Expect healing to take at least 1 week.
Nipple shields. Despite the name, these products do not shield your nipple and can cause irritation. They also increase risk of low supply, engorgement, and mastitis.
Gentian violet can cause tissue ulceration. It’s often used to combat yeast which is very unlikely to infect the nipple.
Epsom salt soaks, tea bags, or excessive use of moist compress can break down skin.
Breast shells can cause swelling in the areola and often increase pain.
Using a hair dryer which will dry out the skin.
Nipple bleb. A bleb can look like a little blister which may be white or yellow on the nipple. Blebs show up when there is deeper inflammation and bacterial imbalance. Treat the underlying mastitis (inflammation) and the bleb will resolve. If you have a bleb, let your Lactation Consultant know. Do not try to squeeze or pop the bleb as that will open the skin for infection.
Vasospasm. If your nipples turn colors after feeding (white, purple, or blue) you may be experiencing vasospasm. This is caused by a constriction of blood flow from nipple damage, poor latch, or topical anti-fungals. Fixing the cause stops the vasospasm.
As always, check with your IBCLC for further guidance.