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Are Sore Nipples Normal?

QUESTION

Dear Lactation Consultant,
I am 32 weeks pregnant with my second child. I would like to breast feed my baby but my nipples are exceptionally tender. I attempted to breast feed my first child but could only stand about 5 days. It was like driving nails through my nipples. Is there anything I can use to desensitize them now and after the baby's born?

My husband mentioned something about a lotion baseball pitcher's use to toughen up their hands and keep them from splitting and bleeding. Can I use something like that or will it effect my baby?

Thank you for your help.

ANSWER

This is an important issue! No one can enjoy breastfeeding if they are in pain.

Regarding nipple soreness, there are some things that are normal and some that are not. For example, tender, sore nipples during pregnancy are normal due to hormonal changes. Most women experience this.

Toe-curling pain, cracks, and bleeding after birth are *not* normal. This is not a natural extension of sore nipples during pregnancy and it is not a sign that you are just "sensitive" and need to be toughened up.

In fact, although we used to think that "sensitive" mothers needed to toughen their nipples, we know now this is not true. Experienced breastfeeding mothers do not develop callouses on their nipples.

There are a number of causes for nipple pain, but by far the most common cause is poor latch-on. The most important thing you can do to avoid nipple pain and trauma is to have a lactation consultant work with you as you learn to latch your baby on.

Sometimes mothers say that the nurses in the hospital have checked their latch and that it looked fine. However, if you have nipple pain and trauma, chances are excellent that it is *not* fine. Once you learn how to make sure your nipple reaches the "comfort zone" in the baby's mouth, breastfeeding should always be comfortable.

There are other causes of nipple pain and trauma, which a lactation consultant can also check for. Things like tongue tie in a baby can cause soreness even with a good latch.

With formula costing a minimum of $1200 for your baby's first year, getting breastfeeding help -- even if you have to pay a lactation consultant to come for a home visit after you leave the hospital -- is a good investment that pays back many times over.

You might also consider taking a breastfeeding class from a board-certified lactation consultant (IBCLC) to learn more about latch-on before your baby is born.

-- Nancy, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.