Why do I have painful nipple blisters?

Since I began nursing I’ve developed blisters over both nipples, and nursing is extremely painful. Is this a latching-on problem, or do I just not have enough milk?

Question:

A frequent cause of nipple pain is improper latch-on. The presence of nipple blisters suggests that friction is created while your baby suckles. These blisters may contain a clear or milky fluid. Usually there is no friction of the tissue during breastfeeding. Friction may occur if your baby is not pulled deeply into the breast when latched-on. Improper tongue placement (as can occur when the glossary linguistic frenulum -- the stringy membrane between the bottom of the tongue and the mouth -- is tight) or poor tongue coordination can also cause friction.

Babies with low oral tone (tongue and/or lips) can also lose their grasp of the breast with each suck, causing friction leading to blisters. (Technically, oral tone is defined by the oral muscles’ resistance to gravity. When the muscle tone is low, these muscles stay in a relaxed state when not in use.) This may be the cause if you hear a smacking noise with some (or many) of the sucks. Sucks should be almost silent with swallows sounding like a loud exhale or gulp.

Try supporting your baby at breast level with pillows or a nursing pillow like “My Brest Friend.” Give your baby a deep hug to latch, and keep your baby close for the entire feeding (your baby’s cheeks against your breast). If this feels more comfortable, you may be avoiding the friction that injured your nipples.

You can use a saline (saltwater) solution to soak your nipples and promote healing. Add one-half teaspoon of salt to eight ounces of warm water. Pour the solution into a small cup (such as a shot glass or medicine cup). Lean forward and place the cups against your breast with your nipples inside. Now you can sit up while maintaining the cup seal against your breast to create a nipple soak. Hold this for three to five minutes. If you experience a burning sensation, you have used too much salt.

Other causes of blisters on the nipples are also important to consider. Herpes lesions can look like blisters and are very infectious. If you have a history of herpes (either I or II), consult with your doctor immediately and avoid allowing your baby to have contact with the area that may be infected.

Another, more benign, cause of blisters is contact dermatitis. If you have been using any ointments, creams or medications on your nipples, discontinue use. A dermatologist can help you diagnose what type of blister you have.

Low milk supply is another possible cause of nipple pain. If this were the case, you would have other evidence of poor supply such as your infant’s poor weight gain, infant dissatisfaction with feedings and inadequate voiding.

Keep in mind that if nipple pain is not resolved it can lead to decreased supply because mothers in pain often avoid or delay feedings. Nipple pain can also interfere with the hormonal responses that assist milk flow. This can cause a diminishing supply.

Nursing your baby should be pain-free. Keep searching for answers until you are able to enjoy it.

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