Crack that nip!

May 6, 2007 11:07 AM

[BreastfeedingFilter] My partner and I just had a baby boy. So far, breastfeeding is going pretty darned well, except...

He seems to be latching pretty well, if maybe a little close to the tip (he has a small mouth). One nipple is holding up famously, but the other has a bit of road rash–there's an abrasion, kind of, right across the tip of the nipple from left to right, that scabs over a bit and is very sore. We're reading all of the books, and are finding lots of advice about prevention of this situation, but precious little about what to do now.

We tend to agree that creams and ointments are most likely not helpful. She tried lanolin for the first couple of days, but has let that go and just spreads breastmilk on the poor, sore nipple. We (she) would be grateful for any advice about how to speed healing. Did you pump on the hurt side? Express by hand? Nurse for shorter periods? How did you keep the flow even on both sides? Compresses? Hot, cold?

Thanks from our whole little family!

posted by al_fresco to health (24 comments total)

Well, um I know someone who swore by something called "udder cream" - sigh, not just for cows anymore...
posted by jkaczor at 11:16 AM on May 6, 2007

I asked my wife (breast feeding second baby) and she said thankfully she has not had a cracked nipple. If the books are no help I would take a look around the net for a lactation consultant in the area. I am sure they would happily give some free advice on the phone.

I remember with our first my wife giving a sore nipple a break through pumping it for a few feedings (rather than feeding directly). If you have a breast pump you might try pumping that breast for a few feedings and see if that helps it heal faster (or at least hurt less!).

I know she pumped at least some pink milk. It is fine to feed the baby pink milk!

FWIW My wife uses lanolin and believes it to be helpful. She has a stack of books, but found Nursing Mother's Companion the most useful (it is on Amazon).

Good Luck!
posted by crhanson at 11:29 AM on May 6, 2007

Kellymom's advice for nipple cracks and abrasions

When I had sore nipples after the baby was born, I used: ice packs, lanolin, pumped from that side to give it a rest from the baby and time to heal, nursed from that side second and nursed for less time, and walked around a lot with my shirt off (air exposure and no fabric to chafe against). It's okay to nurse less from one side but make sure to pump/express if you are so you don't get mastitis or clogged ducts (esp. in those first weeks).

Hope that helps! Congrats on your new addition.
posted by Melinika at 12:18 PM on May 6, 2007

I used lanolin like crazy and my kids seemed to survive it, although my husband was afraid that they'd start to baa as they got older. Seriously, it was the only thing that worked; prescription straight lanolin and even with it I was in quite a bit of pain the first few weeks. After that, though, your nipples toughen up and you'll be okay.
posted by mygothlaundry at 12:19 PM on May 6, 2007

You might try a nipple shield on the bad side - a lot of lactation consultants are very "tsk tsk" about shields, but I think they get a bad rap. I used them for weeks with no problems getting my son to latch later.

Other things I found helpful:

Squirt a tablespoon-sized dollop of Lansinoh or the equivalent onto a contoured nursing pad. Rub it against a second nursing pad so there is an equal amount on the very center of both pads. Place them face up in the freezer. They last forever this way; you can make a bunch. Apply them after every nursing session. Heaven.

Soothies. Awesome. Expensive, but they last a few days.

I really wanted to post one last tip, but I cannot remember the name of the product that they gave me in the hospital. Dammit! Maybe someone can jump in with the name. It is this crazy gel-like sheet that comes on a plastic backing. It's about 4" x 6", and you cut off as much as you need. You can use each cut piece for 24 hours - you wear it all the time and remove for nursing and replace after you're done. It's actually some kind of burn treatment. It's driving me crazy that I can't remember the name.
posted by peep at 12:33 PM on May 6, 2007

peep; it sounds like you're describing artificial skin coverings used to treat burns. You can buy this stuff at a pharmacy. The kind I've seen is a light blue, nearly transparent gel, and it comes in sheets.
posted by odinsdream at 1:03 PM on May 6, 2007

peep: That stuff sounds like 2nd skin.
posted by anaelith at 1:04 PM on May 6, 2007

My wife (nursed our daughter to age 2, currently feeding our three-week old) swears by APNO, or "All Purpose Nipple Ointment" - Requires a perscription, and an old school Rx that can mix compounds, but the stuff is magic. Makes lanolin seem like a placebo. Expensive but a tube lasts for many weeks.
posted by jalexei at 1:04 PM on May 6, 2007

Peep- probably Water-Jel or 2nd Skin
posted by headspace at 1:07 PM on May 6, 2007

I know time is probably really tight right now, but the hospital should have both lactation consultants and a nursing support group. My wife found both to be helpful and encouraging, and they had a number of suggestions to help us with problems like the one your wife has now.
posted by Alt F4 at 1:47 PM on May 6, 2007

Kellymom is a fantastic site. Note that rubbing breastmilk on the nipple actually provides many protective qualities. My community health nurses (who also serve as lactation consultants) told me that breastmilk is just as protective as lanolin, if not better.

Try calling your local La Leche League. They have volunteer lactation consultants who can provide advice and support. You could also look into hiring a lactation consultant. But your profile says you're in Berkeley, so I imagine the La Leche League near you is excellent.
posted by acoutu at 1:53 PM on May 6, 2007

If you do call La Leche League be aware that they are zealots. (As in, advising people to breastfeed up to and including age four.) So take their practical advice but if you start trying to pump you full of philosophy, back away slowly.
posted by DU at 2:10 PM on May 6, 2007

My daughter had that on one side too. IIRC she kept feeding but did use some kind of breast cream. (The baby is four months old now and things are just peachy.)
posted by konolia at 2:17 PM on May 6, 2007

My nurse told me "there's nothing you can do but rub your own milk on it" when I had a cracked right nipple which scabbed ugly and hurt like nothing else. I used my own milk, I pumped from that breast the days that it was too painful to nurse, and I took long hot showers so that I empty out that breast manually after it had healed as I seemed to be close to or actually a clogged duct in there. (which also hurt like nothing else)

Best wishes to the little family and I hope mom gets better soon. Once she's past all this the nipples toughen up and it's much easier.
posted by dabitch at 2:18 PM on May 6, 2007

I think the big thing to deal with here is that it's REALLY painful and yet you want to keep on nursing because of all the bennies; health, immunity, intimacy ,etc... so what it takes besides getting through this is the commitment to get through it... I'd try any of the plausible suggestions and know that the nipples toughen up and it's no longer painful. Best wishes to you
posted by lois1950 at 2:48 PM on May 6, 2007

1. Mom should be as cozy and comfortable as possible, with back support, arm support, and a pillow under where the baby is going to be.

2. Next lay the baby across the pillow, so his body is FACING HER BODY. If he has to turn his head, that's not the optimal position.

3. The baby has to open his mouth as wide as possible - and - in that super wide moment, put HIM onto HER nipple (not the other way around.

4. If it's hurting a lot, break the suction, take him off, and repeat steps 1-3.

5. To heal the nipple, expose it to air as much as possible, she should have naked breasts all the time if possible. Express a little breastmilk and rub that over the nipples. Try a little topical antibiotic if it seems t be getting infected, and then just wash the breast before nursing. Note that it's also totally OK for her to take some ibuprofin, and I would encourage that for a few days.

6. She needs to keep nursing both sides to avoid getting a blocked duct, but she doesn't have to nurse for long on the super-owie side. Also, she should try the football hold or another position so the nipple isn't getting irritated in the same spot over and over.

Finally, there are a bunch of very good (if expensive) lactation consultants in the bay area (you're still in Berkeley?) The most well known is Janaki Costello. Here's more suggestions.


Just remember, THIS WILL GET BETTER!!!! In a couple weeks, this will be totally behind you, and in a couple months she'll be able to breastfeed while standing in line at the grocery story. This, like all aspects of parenting, require patience.
posted by serazin at 4:21 PM on May 6, 2007

Tiny infants sometimes don't have the mouth strength or size to suckle perfectly; my solution was to pump for a few weeks and give her a bottle (My First Year Breastflow) most of the time, until she got the hang of breastfeeding. It worked great for me b/c the bottle I chose limited nipple confusion. Good luck, I feel for her!
posted by pomegranate at 5:35 PM on May 6, 2007

My wife had very sore nipples 'til she got some very pure lanolin. Not the stuff available at the average big-box drug store, but some stuff she found at an online health store that went on very thick and sticky. After about a month, she didn't need it anymore, and I can't find the stuff to give you a name. I thought it was something like LanoPure or PureLano.
posted by Bradley at 6:07 PM on May 6, 2007

Secdonding the All purpose Ointment. Great stuff. Also, it could be the baby might not be latching on to enough of the pores to draw out the milk. I'd get clogged nipple pores (very different from clogged ducts) all the time with my first.

What helped was getting larger horns for the pump. I used the Medela Lactina Select medical/rental pump - much more powerful than the individual ones sold by the same company. They say it's the same engine inside, but the difference is in the length and strength of the stroke. Between that and the larger horns she may get better coverage over the whole nipple. (I called it the "luggable" pump.)


There's a larger pump one that you really can't move but that has an even longer pull, which may be more comfortable.

Laws vary from state to state, but if you're elligible for WIC benefits, they might be able to get you a pump for free.

Also seconding nekkid nipples. cotton undershirts are the most I would do. That was hard for me at work, "swinging free", but I wore a lot of vests to camoflauge.

(Heh, and as a side note, the boys were born two years apart, and I ended up nursing for four years total.)
posted by lysdexic at 8:12 PM on May 6, 2007

Oops. Others also mentioned changing baby's position. She can do this by lying down on the bed and placing the baby's top lip over the problem area. I've tried it, but it's not as good as the pump - at least the pump won't start crying out of frustration.

And also, congrats!
posted by lysdexic at 8:14 PM on May 6, 2007

The abrasion is coming from the nipple rubbing against the roof of the baby's mouth. She needs to get more of the bottom of her areola in the baby's mouth. When I started nursing, it wasn't working out too well despite all the reading I'd done and the nurses yelling "figure it out, or we'll give him formula." So I stuck my finger into my son's mouth to feel exactly how my nipple was supposed to fit. And everything clicked for me then. It's been my mission to tell everyone about this techinque since then.

As everyone has already said, Lansinoh or breast milk rubbed on the nipple is the preferred treatment. I went the milk route, keeping my nipples exposed so the milk would air-dry. I finally got a gift of Lansinoh after I had gotten over the nursing difficulties, and was sorry I didn't have it earlier.

Ice packs are great too. I used the ol' frozen cabbage leaf in the bra on days I was painfully engourged, and found it also works well as an ice pack you can wear in public. Don't worry about cabbage smell - at this point, the baby smell is still covering it up.
posted by Iamtherealme at 10:16 PM on May 6, 2007

Great advice here already. Soothies gel pads are a super relief. I definitely recommend seeing a lactation consultant. I thought I was just having the typical soreness and was being a pain whimp but it turned out I was really injured on both sides and had to start pumping to heal while we figured out how to make things better (it takes 2 to breastfeed properly and you're both novices!). A few exhausted weeks later we got it all worked out. As others have described, one trick is to get as much of the breast into the baby's mouth as possible when the mouth is open wide. It's easier to have someone show you this trick than to describe it. So get an expert opinion on whether you can change anything to help or whether your pain will go away soon. Congratulations, and stay upbeat -- you WILL work it out!!!
posted by girlhacker at 10:55 PM on May 6, 2007

Ah, thanks lysdexic, now I learned that was I had was a milk blister, not a clogged duct.

Sending more 'hang in there' cheers to the little family. It's rough now but like serazin said, soon she'll be able to nurse anywhere anytime. Make sure mom has nice water around, sometimes when it just won't work, relaxing and drinking water is the only thing you can do to get it flowing again.
posted by dabitch at 12:03 AM on May 7, 2007

Oh! Speaking of water, my baby was MUCH more relaxed in the tub, and so was I - our first truly successful breastfeeding moments all happened there. (Of course I was spending a lot of time there anyway trying to get my girlparts back in order.) You might try it. I also second the side-lying and would only add that there was a study recently citing prone breastfeeding as the chosen position leading to most success.
posted by pomegranate at 6:37 AM on May 7, 2007