Cracked and bleeding nipples got you down?
I know your story. I’ve heard it a hundred times and have lived it myself. You’re somewhere in the first few weeks of breastfeeding. You did your homework and read all the things about what a good latch should look like. You saw a lactation consultant when your baby was born and you’ve watched all the videos you can find on latching your baby. I believe you when you say that you’ve worked harder at this than anything else you’ve ever done in your life. I know that the fact that you’re still dealing with cracked and bleeding nipples and excruciating pain might mean that giving up is the only solution you can think of. I know because I was you 12 years ago. I also went on to nurse 2 other babies virtually pain-free for 2 and 3 years, respectively, and now I know that I didn’t know what I didn’t know with my now-12-year-old.
That sounded confusing. Let me simplify things for you.
I want to talk about, as a root problem, what the singular issue is that causes most nipple pain and trauma and invite you to think of the relationship between yours and your baby’s anatomy in a new way. This is a relationship that you must understand in order nurse pain-free. There’s likely one issue that nobody has explained to you and reading this might just be your “aha!” moment.
One word sums this issue up quite simply: friction. Friction is the force resisting the relative motion of solid surfaces, fluid layers, and material elements sliding against each other. Friction, in relation to all things having to do with nipples, is the one thing that you want to avoid and the primary culprit in most nipple pain. Friction is bad for your nipples. It makes them crack and bleed and that’s… well, in a word, unpleasant.
Before I tell you how to avoid friction while nursing, I want you to understand why and how it happens. Run your tongue across the roof of your mouth and notice the textures you find. Start at your top teeth and go backward slowly. You’ll notice the firm ridges of tissue as you glide your tongue across your hard palate. If you have a healthy baby with normal anatomy, his mouth is very similar to yours, just on a smaller scale. The place you felt the firm ridges of tissue in your own mouth is the place in your baby’s mouth where you’ve likely recently been repeatedly sending your nipples to be tortured.
Move your tongue further back and you’ll feel a place where the roof of your mouth transitions to softer, smooth tissue and beyond that, a very squishy spot without bone underlying the tissue. This is your soft palate. It’s also the place in your baby’s mouth that is the holy grail of pain-free nipples and it’s the promised land you’ve been seeking. The answer to preventing most nipple pain is avoiding your nipples ever being in contact with baby’s hard palate. Friction against the hard palate is comparable to taking sandpaper to your nips and you’ve likely been doing it since your nipple pain started.
Let’s talk about the 4 times you might be power-sanding your nipples and how you can fix it:
- When you compromised with your baby about opening his mouth during latch on. Insist, on every latch, that your baby opens his mouth to a wide gape before you allow him to go onto the breast. Allowing your baby to slurp your nipple into his mouth like a spaghetti noodle rather than come onto the breast with a wide, open gape means that it will land in his hard palate. He may or may not pull it back into the soft palate as he starts to nurse, but if he does, he’ll be raking it across his hard palate as it moves and we all know what that means, right? Just say no to powersanded nipples by insisting that when baby latches on, his mouth is wide open so that you can facilitate a deep latch and insure your nipple lands where it’ll be comfy, back in the promised land of his soft palate. If he’s doing it wrong, don’t compromise for the sake of making things easier for him. In fact, if you need to wait for him to cry before latching him on in order to get that wide open gape, don’t be scared to do that. He’ll thank you for it later when you’re still nursing him instead of weaning because the cracks in your nipples look like mini Grand Canyons.
- When you latched your baby onto the breast by putting the breast into his mouth instead of pulling him onto the breast. Actually, it’s not the act of putting the breast into baby’s mouth that’s the problem. It’s what happens afterward. Leaning forward and pulling your breast into baby’s mouth means you’re putting yourself into a very uncomfortable posture that’s hard to maintain. You’re probably going to start to sit up through your nursing session because your lower back will hurt from being hunched over at the waist and, in doing so, you’re likely to let baby slide to the end of the nipple rather than keeping baby tucked into the breast. Instead, sit up straight and pull baby onto the breast and into correct position as you latch him on. Keep that position as you nurse and use pillows to help make yourself comfortable as you keep baby tucked firmly into the breast. Speaking of keeping baby tucked into the breast…
- When you didn’t keep baby tucked firmly into the breast throughout each feed. Once you get that nipple back into the heavenly, pain-free spot in the back of baby’s mouth, keep it there. Keep him tucked into the breast so that he doesn’t slide down and land your nipple forward in his mouth and into the powersanding zone. Baby’s chin should be tucked into your breast and his nose should be nearly touching it. If it is touching it, that’s fine, too. The skin around your nipples and areola shouldn’t be stretched at all. It should be loose and without tension on it. He can still breathe out the sides of his nose and simultaneously nurse, I promise. If he can’t breathe, he’ll open his mouth, which might actually be a good skill for him to learn and brings me to the 4th time on this list that nobody told you to stop power-sanding your nipples.
- When you let your baby to “pop off” of the breast after a feeding or pull at your nipples during a feed.
When baby unlatches, he should open his mouth while he’s still in good position and maintaining a good latch rather than pulling off of the breast with suction still intact. What happens when he pops off or pulls at your breasts is, you guessed it, powersanded nipples. Even a split second of friction on your nipples adds up when you’re nursing 8-12 times a day and sometimes latching on and off a couple of times per feeding. Teaching him to open his mouth wide as he comes off the breast is actually a fairly simple task, maybe the simplest one on this list. First push baby into the breast and then, stick a finger from your free hand into his mouth. There won’t be a lot of room between his face and your breast and it might be cramped, but you want to break the suction before baby moves down on the breast and not AS he’s moving down. This is, again, in an attempt to avoid that bumpy area of tissue in his hard palate where you’ve been torturing your nipples recently.
It might not sound like such sage advice, but I promise you that considering where your nipple is in your baby’s mouth at all times is one of the best ways to prevent nipple pain and trauma. It’s fairly simple if you’ve got a baby who isn’t dealing with nipple confusion or tongue tie or any of the other myriad things that might be affecting his latch. For more information or hands-on help, call me or one of the other BBC Peer Counselors for a free phone or in-person consult!
Amy is mom to 4, ages ranging from 20-7. She’s a homebirthing VBAC mama who is also a WMC Doula, a student midwife, a peer counselor with the Beaumont Breastfeeding Coalition and a local birth rights activist. She and Heather Thomas founded WMC in 2006 and passionately work to improve local birth and parenting options for Southeast Texas families.