Nipple, Cracked

Cracked nipple  is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. The mother with a cracked nipple can have severe nipple pain when the baby is nursing. This severe pain is a disincentive for continued breastfeeding. The crack can appear as a cut across the tip of the nipple and may extend to its the base. Cracked nipples develop after the birth of the infant and is managed with pharmacological and nonpharmacological treatment.

Some studies indicate that cracked nipples are caused by poor latch.Yet other causes could be poor positioning, use of a feeding bottle, breast engorgement, inexperience, semi-protruding nipples, use of breast pumps and light pigmentation of the nipples.

If your cracked nipple was caused by a positioning problem, here are some tips on establishing a good nursing position:

  • Have several small pillows available to support your arms and your baby. Nurse in a comfortable chair, or surround yourself with pillows if you're nursing in bed. Put one pillow behind your back, another on your lap, and a third under the arm that you'll use to support the baby.
  • Rest your feet on a low footstool  so your knees are raised.
  • Hold the baby at breast level. The pillows should be supporting your upper body-arms and shoulders-and your lower back. If those areas feel strained, reposition yourself.
  • Check the baby to make sure she also feels supported and secure. If she's tense, she can't concentrate on nursing.
  • Hold your breast with one hand. Cup it with your thumb above-but not touching-the pink/brown areola, so your fingers and palm support the breast from below. Tickle your baby's lips with your nipple. If she doesn't open her lips, express a little milk and dab it on her mouth. When she opens her mouth, bring her quickly to your breast.
  • Make sure she gets a big mouthful of breast. Your whole nipple should be inside her mouth, and a good measure (an inch) of areola as well. 
  • Support the baby, if necessary, at her shoulders, instead of her head. Make sure her body is in a straight line from ear to hip. Cuddle her close. Her chin and nose should be in contact with your breast throughout the session.
  • Watch her as she suckles. Are her lips pulled in, or flanged out? If they're pulled in, fold the lip out. 
  • Listen as she nurses. If she clicks, slurps, or gasps, she may have a poor latch-on

Treatment:

Cracked nipples can be treated with 100% lanolin. Glycerin nipple pads can be chilled and placed over the nipples to help soothe and heal cracked or painful nipples. If the cause of cracked nipples is from thrush, treatment is usually begun with nystatin. If the mother is symptomatic then the mother and the baby can be treated. Continuing to breastfeed will actually help the nipples heal. A little breast milk or purified lanolin cream or ointment helps the healing process. Breastfeeding professionals that include nurses, midwives and lactation consultants are able to assist in the treatment of cracked nipples.

Prevention:

The nipples of nursing mothers naturally make a lubricant to prevent drying, cracking, or infections. Cracked nipples may be able to be prevented by:

  • Avoid soaps and harsh washing or drying of the breasts and nipples. This can cause dryness and cracking.
  • Rubbing a little breast milk on the nipple after feeding to protect it.
  • Keeping the nipples dry to prevent cracking and infection.

  • Clinic 1
    Dr. Hemendra Gupta's Child Care Center
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