Itchy nipple

I've successfully nursed my baby since birth -- he was exclusively on breast milk until yesterday evening, when he started eating rice cereal mixed with breast milk. The problem is this: I've been noticing that my right nipple has been very itchy. Now it is very sore, both in pumping and nursing (which he's been doing several times a night lately). The nipple is also enlarged and swollen, and much larger than the left one.

I haven't noticed any signs of thrush. He was on antibiotics for 10 days and his cycle of the amoxicillin ended a week ago today.

I'd like to use lanolin, but the label says that it shouldn't be swallowed. Does that mean carefully wash it off?


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Itchy, sore nipples can be caused by several factors:

  • Nipple Eczema. Do you have a history of eczema (atopic dermatitis) or dry, sensitive skin? When eczema is present your nipples may be red, flaky, itching, oozing and/or inflamed.
  • Thrush. With "nipple candidiasis", a fungal infection, you may begin experiencing intense nipple pain with burning and possibly itching Your nipples may be slightly pink to red in color and may appear to have a sheen. If your baby is also affected he may have white plaques inside his mouth, a white sheen to his lips, and/or diaper rash.
  • Contact Dermatitis. It is not unusual for a nursing mom to have a reaction to food particles remaining in her baby's mouth. This is often more painful for moms at the time of ovulation and in the week of menstruation (if your menstrual period has resumed.)

Some simple tips you might want to try are:

  • When you shower, wash your nipples using only plain water, lukewarm water. Do not use soap, which can be very drying, particularly to sensitive skin.
  • Rinse your nipples gently with plain waterafter feedings. Allow to air dry or pat gently with a soft cloth.
  • Apply a pea-sized amount of Lansinoh to each nipple and areola after feedings. This type of purified lanolin does not need to be rinsed off prior to nursing.
  • Encourage your baby to take a sip of water before nursing to insure no food particles remain.
  • Use a gentle detergent in your laundry. Double rinse your wash to remove any soap residue that may be irritating your nipples.
  • Ask your doctor about using Ibuprofen 20 to 30 minutes prior to nursing or expressing to relieve pain and inflammation.

Because all of the above conditions present in a very similar way, it can be very difficult to determine the cause of your nipple pain on your own. If these symptoms persist, see a dermatologist who's knowledgeable about breastfeeding for a thorough evaluation.

Because other conditions, such as Paget's disease, a rare form of breast cancer, can present similarly to eczema, it is important to be evaluated by your doctor if your symptoms do not respond to treatment.


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