How to Heal Sore or Cracked Nipples

Virtually all breastfeeding moms have experienced nipple pain to some degree. The journey of breastfeeding can be full of sweet, quiet moments of bonding with your baby, but sometimes it’s actually really difficult and not so sweet, and it just hurts! The discomfort of sore nipples can turn what should be a beautiful moment into a painful one. However, there are several effective strategies to soothe and heal sore nipples while keeping your breastfeeding journey on track. 

What Causes Sore Nipples

When dealing with nipple pain, the most important thing is to understand what might be causing the pain to prevent persistent or worsening breakdown and pain. The root cause of the pain may help determine what strategies will be most effective for finding relief. Some of the most common causes include:

How to Heal Sore Nipples

If you’re already dealing with sore nipples, don’t worry! There are plenty of ways to relieve the pain and support healing. Here are some tried-and-true remedies:

Correct the Latch

Poor latch and/or poor positioning is the most common reason for nipple pain and soreness. Your first goal should be to improve your latch and positioning. If you suspect that a poor latch is causing the soreness, gently break the suction with your finger and try repositioning your baby. Not sure what to look for in a latch? Check out my Ideal Latch Handout here for the breakdown!

Silverettes

It is well known that silver has antimicrobial effects and has been used in medicine for centuries. They have been shown to effectively heal nipple damage and reduce pain, without irritating the skin. Just remember that silverettes should not be used in combination with nipple cream–it’s just one or the other to ensure maximum effectiveness! 

Breast Shells

Wearing breast shells between feedings gives the nipple space to heal and prevents friction between the nipple and bra.

Breast Milk

By applying a small amount of breastmilk to the nipple and letting it air dry, you can rely on the antibacterial and antimicrobial properties as well as the antibodies found in breastmilk! If your nipple pain is very mild, this might be enough for you. But most moms will find more relief by using this method in combination with some other strategies. 

Nipple Cream

Apply a small amount of nipple cream directly to the nipple after each feeding and cover with a breast pad or shell. Creams with lanolin are popular, but can actually be quite drying and irritating and haven’t been shown to be very effective. I prefer to use something with calendula flower extract because it has been shown to be anti-inflammatory, antibacterial, and anti-fungal and aids in wound healing.

Medihoney Honey has been used for thousands of years for wound healing due to its natural antimicrobial and regenerative properties. Medihoney is a medical-grade honey that has been sterilized to ensure the inactivation of bacteria and spores that may be present, making it safe for use during breastfeeding, though it is recommended to wipe off any excess product with a warm washcloth prior to feeding. You can use Medihoney like you would any other nipple cream by simply applying a small amount after feedings followed by a breast pad or shell to protect the nipple and help the product absorb.

All-Purpose Nipple Ointment All-purpose nipple ointment (APNO) is a medication that must be prescribed by a doctor and mixed at a compounding pharmacy. It is a combination of three medications--an antibiotic, an antifungal, and a steroid. It's recommended only to use APNO if nipple pain and soreness is not resolved after trying regular nipple creams without success. It's also only for short-term use. You should begin to experience relief within a few days, and should discontinue use by 7-10 days due to the potential risk of skin thinning from prolonged steroid use. As always, APNO should be used as a tool alongside other measures to address the root cause of the nipple pain/damage.

Active Skin Repair Active Skin Repair is a non-toxic, medical-grade skin and wound repair spray that can be used to treat nipple damage. It has antibiotic and antiseptic properties to help prevent infection while naturally promoting healing. It works so well and also has tons of other uses--think skinned-knees, small cuts, rashes, sunburns, etc.

Hydrogel Pads

These cooling gel pads provide instant relief from pain and help with the healing process. They can be worn inside your bra between feedings in place of a traditional breast pad or shell. Make sure to change them regularly to avoid bacterial growth.

Bonus tip! Store them in the fridge for extra cooling benefits!

Saline Soak

Saline soaks can be done to help heal nipple damage and reduce swelling and inflammation. To make saline solution at home, dissolve 1/2 tsp of salt in 8 oz warm water. Alternatively, you can buy saline solution premixed at most pharmacies. Soak the nipple for 1-2 minutes, up 7-8 times per day, after pumping or nursing. Then follow it up with nipple cream and a clean, dry breast pad. Avoid soaking the nipple for longer than 2 minutes as this can actually start to worsen the problem and delay healing.

Trigger a Letdown First

Eliciting a letdown by hand expression or a hand pump before putting baby to the breast can sometimes decrease the level of pain while nursing. If the pain is only on one side, you can try nursing on the “good” side first and then switching to the other side when you have a letdown. 

(Re)Measure Flange Size

If your nipple pain may be related to friction from pumping, it’s a great idea to evaluate your flange fit to make sure it’s correct. Nipples can change during your breastfeeding journey, so it’s possible you need to change sizes. For help with measuring your flange size, download my Flange Sizing Cheatsheet here! 

Take A Break

Even though it will likely still be uncomfortable, some women find the consistency and predictability of the breast pump preferable when experiencing sore and damaged nipples. Use hand expression or breast pump for a feeding or two to give the sensitive and/damaged tissue a breather. 

Check with your Provider or Lactation Consultant

A lactation professional will be able to evaluate you and help you get to the root cause of your pain. You and/or your baby may need to be evaluated for complications such as thrush, tongue tie, etc. If the pain persists, your nipples are itchy or burning and your baby has white patches in their mouth, or if you show other signs of infection such as fever, chills, redness around the breast, etc., you should contact your provider for evaluation.

All of my tried & true, go-to products for healing sore nipples in one spot 👇🏻

Prevention Tips: 

Preventing sore nipples is ideal, as it allows you to enjoy breastfeeding without pain. Here are a few simple tips:

• Ensure proper latch & positioning
• Proactively & liberally use silverettes, nipple Creams, breast Shells, etc.
• Avoid harsh soaps or other irritants
• Wear a comfortable, breathable nursing bra

Final Thoughts

Recovering from childbirth can be overwhelming and obviously uncomfortable, so I don’t want the discomfort of sore nipples to hold you back. By focusing on prevention, correcting latch issues, and using gentle healing methods like nipple cream, silverettes, etc. you can hopefully find relief and continue on towards your breastfeeding goals.

If you’need more in-depth guidance on these strategies, or if you’re hoping for advice for nipple pain caused by specific issues such as flat or inverted nipples, thrush, vasospasms, etc., I put together a comprehensive guide packed full of practical tips, research-based strategies, and product recommendations. With the right support and care, you can get back on track. Check it out at the link below!