Linda C. Donovan, MHA, RN, IBCLC

“If breastfeeding is supposed to be “natural”, then why are my nipples so sore?”

“My mother breastfed me without any problems, so I won’t need to attend the breastfeeding classes or use the expertise of a lactation consultant.”

“Everything was going great with breastfeeding until my baby turned 3-weeks of age and my nipples became sore, so I had to stop breastfeeding”. 

These are a few of the many questions or concerns that a new mother may have when breastfeeding. Unfortunately, for some women, breastfeeding does not always come naturally. What’s more, even though many mothers breastfeed without any problems, there are questions or concerns that she may want to ask a lactation consultant. 

Sore nipples are the second most common reason that mothers quit breastfeeding before their desired goal. It is a fact that the best treatment for sore nipples is prevention and early intervention. The best prevention is learning to latch the baby on correctly from the beginning. Often times, once the mother gets home from the hospital or birth center and her milk comes in, she may complain of sore nipples and more difficulty with latching the baby. Therefore, it is priceless to arrange for a lactation consultant for when you get home; this will reinforce your progress and assist you with all your questions and concerns.

 Most of the time, sore nipples are due to one or both of two causes:

The baby may not be positioned or latched onto the breast correctly, 

On the other hand, he may not have a proper suck.

Babies learn how to breastfeed by practicing the skill. When babies are latched on correctly and getting milk from the breast, they quickly learn the positive effects. However, babies can still get milk, even though, not as effectively, when not latched correctly and mom complains of soreness. Unfortunately, it is not uncommon for women to experience difficulty positioning and latching the baby on to the breast. For that reason, a red flag should go up when a mother complains that her nipples are sore. Furthermore, if the baby is not positioned and latched correctly, he will not get enough milk and this will ultimately result in a poor milk supply for the mother.

An experienced lactation consultant will be able to assess the problem and make the necessary adjustments as needed. It is highly recommended that a new mom take a breastfeeding class taught by a skilled lactation consultant before her baby is born; this will ensure her success; as well as provide her with valuable knowledge.   

Helpful Hints for Positioning and Latch to help Prevent Sore nipples.

      Good positioning will facilitate a good latch on the breast. There are several different positions to hold your baby; however, the cross cradle hold is the preferred hold over the cradle hold simply because there is more control of the baby’s head. Thus, it will be easier to learn and become comfortable with breastfeeding. Some mothers are not comfortable with holding their infant in this hold; therefore, attending a breastfeeding class before your baby is born will add to your success as well as teach you the skills to nurse your baby in this and other positions.

Adapted from:

Place one to two pillows on your lap in order to support your newborn. 

Position your newborn on his side, with his tummy facing your tummy.

Support your baby so that your hand rests between your baby’s shoulder blades supporting his head and the back of his neck; not behind his head Thus, if you are nursing on the right breast, your baby will be supported with your left hand (see above photo).

Cup your breast with your free hand in a “C” hold. Adapted from:


Encourage your baby to open his mouth by lightly stroking his lower lip with your nipple.

Quickly place your nipple and areola in your baby’s mouth, bringing him close to your breast. Be sure that your baby gets enough of your nipple and areola into his mouth. 

Your baby should be approaching the breast with his head slightly tilted backwards. Then, the nipple automatically points to the roof of his mouth

For some mothers, the first few days alone can cause some initial soreness. There are many creams on the market to treat sore nipples. Certain creams may promote healing; however, others could cause more damage. Avoid creams that are drying to your skin and discuss the different creams with a lactation consultant.

When Sore Nipples is due to fungal infections or thrush When the nipples have knifelike pain, become red and burn, are itchy or stinging or feel exceptionally sore weeks or even months of pain-free breastfeeding, it may be due to a fungal infection ( due to Candida albicans). Your baby may present with white patches in his mouth or the yeast infection may show up as a bright red diaper rash that does not heal with regular diaper rash cream. He may also be fussy and may lose interest in breastfeeding. There are several different treatment plans that include prescription medication as well as safe alternative therapy to treat yeast infections. Contact your lactation consultant and baby's physician for more information and treatment.

Other reasons for sore nipples There can be other reasons for sore nipples. Most of these other reasons are less common; nevertheless, they can be troublesome. A few of these reasons can include, but are not limited to a baby who is tongue tied, or has what is known as a disorganized suck. For the reason that a correct latch is crucial in preventing sore nipples, it is always advisable to contact a lactation consultant for an evaluation, especially if the soreness persists for 24 hours or more. 


As health care professionals, we recognize that breastfeeding is the best way to nurture and provide nutrition for the newborn for up to a year. However, there may be situations where the mother complains of sore nipples or other concerns.


Breastfeeding is not always perfect in the first few days or sometimes weeks after a baby is born. The mother needs a lot of encouragement and reassurance at this time. It is up to the health care providers to assure that the mother is getting off to a good start with accurate information. 

Linda C. Donovan, MHA, RN, IBCLC, is the owner of Peaceful Beginnings and Peaceful Beginnings Boutique. She teaches monthly breastfeeding classes. Linda will meet with women before and after the birth of their baby. She is also available for home lactation visits as well as outpatient visits in her office after discharge from the hospital or birth center. For more information, contact Linda at 336-851-9552 or