Some nipple tenderness in the first few days of breastfeeding is common. The Australian Breastfeeding Association describes it as mild soreness that eases as the feed continues and usually settles after a few days. Pain that lasts the whole feed, comes at every feed, or comes with cracked or bleeding nipples isn't normal, and the NHS says it needs help.
The most common cause is a shallow latch, so that's the first thing to fix. This guide covers how to tell normal tenderness from damage, the other causes worth knowing about, first aid that helps, what to do if feeding is too painful, and when to see a doctor.
Is it normal for nipples to hurt when breastfeeding?
A little, briefly, at the start. Here's how the NHS and the Australian Breastfeeding Association describe the difference.
| Usually normal | Needs help |
|---|---|
| Tender in the first few days | Pain lingers or gets worse after the first week |
| Eases as the feed goes on | Hurts through the whole feed or at every feed |
| Nipple looks normal after feeds | Nipple flattened, wedge-shaped or white |
| Skin intact | Cracked, blistered or bleeding |
| Comfortable between feeds | Burning, stabbing or itching between feeds |
Pain that starts after a stretch of comfortable feeding is also worth checking, as it can point to an infection or another cause.
What causes sore nipples when breastfeeding?
The Australian Breastfeeding Association's guide to why nipples get sore lists these causes.
| Cause | Clues |
|---|---|
| Shallow latch (most common) | Nipple flattened after feeds; a line of redness or a white stripe |
| Tongue-tie, high palate, flat or inverted nipples | Hard to get a deep latch despite good technique |
| Breast pump | Poorly fitting flange, suction too high |
| White spot (bleb) | Small pale blister that hurts during and between feeds |
| Infection (bacterial, fungal or viral) | Cracks that don't heal, redness, shiny or flaky skin, burning or stabbing pain |
| Dermatitis or eczema | Itchy, red or flaky skin; may be triggered by creams, detergents or breast pads |
| Vasospasm | Nipple turns white then blue, purple or red; pain in the cold or straight after feeds |
| Biting | Often around teething |
| Hormonal changes | Sensitivity around periods or in a new pregnancy |
The NHS tongue-tie page says tongue-tie can cause sore nipples, along with signs in your baby such as difficulty staying latched, clicking and long, frequent feeds.
How do you fix sore nipples caused by the latch?
The NHS says self-help tips won't work until your baby is properly latched, so start here.
- Bring your baby to you, tummy to tummy, nose level with your nipple, and wait for a wide gape before bringing them on chin first.
- Aim for a big mouthful of breast, with more of the areola visible above the top lip than below the bottom lip.
- Break the suction with a clean finger in the corner of your baby's mouth if it pinches, and try again.
- Try a different position. Many parents find changing the angle takes pressure off a sore spot.
- Don't cut feeds short. The NHS Best Start in Life page on sore nipples says shortening feeds won't ease the pain and may lower your supply.
- Ask someone to watch a feed. A midwife, child-health nurse, lactation consultant or a breastfeeding helpline (the Australian Breastfeeding Association on 1800 686 268 in Australia, the National Breastfeeding Helpline on 0300 100 0212 in the UK) can often spot the fix in one visit.
For full step-by-step help, see latch and positioning. If you pump, check your flange size and keep suction gentle.
How can you soothe and heal sore or cracked nipples?
These first-aid steps come from the Australian Breastfeeding Association's first aid for sore nipples and the NHS.
- Warm compress: lightly press a warm, wet cloth onto your nipples for about 5 minutes after each feed.
- Breast milk: gently rub a little expressed milk onto the nipple and let it dry.
- Keep it dry: change breast pads at every feed, and check that pads, bras or hydrogel pads aren't trapping moisture against the skin.
- Soft, breathable clothing: a cotton, non-underwired bra that doesn't rub.
- Unstick pads gently: if a pad sticks, dampen it with a little milk before peeling it off.
- Go gentle on skin: use soap-free washes and a mild laundry detergent. The NHS says soap can dry the skin.
What about creams? The Australian Breastfeeding Association says research suggests creams and ointments may not work better than simple measures like breast milk. The Academy of Breastfeeding Medicine's 2022 protocol advises against saline soaks for nipple damage and against scrubbing or cleaning the nipple, which can make skin soggy and painful. The Australian Breastfeeding Association also says silver nipple caps shouldn't be used on healthy nipples.
What if breastfeeding is too painful right now?
You don't have to grit your teeth through every feed. The Australian Breastfeeding Association suggests:
- Rest the nipple for about 12 to 24 hours to let it start healing.
- Keep milk moving by expressing about as often as your baby would feed. Hand expressing is often gentlest, though a pump can work.
- Feed the expressed milk by cup rather than a bottle, to protect breastfeeding.
- Go back to the breast once the nipple starts to heal and it feels manageable.
Nipple shields are sometimes used, but the NHS advises avoiding them because they don't improve attachment, and the Australian Breastfeeding Association recommends in-person help from a lactation consultant or breastfeeding counsellor before trying one.
Is it thrush, vasospasm or something else?
Burning pain is often blamed on thrush, but it has several possible causes, and they need different treatment.
Thrush
The NHS page on thrush and breastfeeding describes burning nipple pain, especially after feeds, itchy or sensitive nipples, and shiny or flaky skin. In your baby, look for creamy white patches in the mouth that don't wipe off. The NHS says to have your baby's latch checked first, because thrush may not be the cause, and your GP may take swabs.
The ABM goes further for deep breast pain: it says there's no scientific evidence for "candida mastitis", the idea that yeast causes deep, shooting breast pain. Try not to self-diagnose or self-treat thrush.
Vasospasm
The Australian Breastfeeding Association's vasospasm page describes a nipple that turns white, then blue, purple or red as blood flow returns, with sharp, burning or stinging pain, often straight after a feed or in the cold. It's more likely if you have a family history of Raynaud's or often have cold hands and feet, or if the nipple has been damaged by poor attachment or infection. What helps:
- feed in a warm place and cover your nipple with your hand as soon as your baby comes off
- skip air-drying after feeds (this differs from general NHS advice to let nipples air out)
- try breast warmers or wool pads
- avoid smoking and caffeine, which can make it worse.
Infection or dermatitis
The Australian Breastfeeding Association's nipple infections page says a doctor will check for other conditions with similar symptoms, such as dermatitis or vasospasm, and that causes like tongue-tie should be ruled out first. It's usually safe to keep feeding during a nipple or breast infection; if your doctor suspects herpes sores, don't feed from that side until they heal — express from it to keep up supply, but throw that milk away.
When should you see a doctor about sore nipples?
See a doctor the same day if you have a hot, red or painful area of the breast with fever or flu-like symptoms, which can be mastitis — see mastitis. Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) if you have signs of sepsis, such as fast breathing, confusion or blotchy skin — the NHS sepsis page lists these as reasons to call an ambulance.
Book a GP appointment soon if:
- cracks aren't healing or there's no improvement after a few days of first aid
- you have burning, stabbing or itchy pain between feeds, or shiny, flaky or red skin
- your nipple turns white or blue and the pain isn't settling with warmth
- your baby has white patches in the mouth that don't wipe off
- you need pain relief — ask which options are suitable while breastfeeding.
Get feeding support early — from your midwife, child-health nurse, a lactation consultant or a breastfeeding helpline (the Australian Breastfeeding Association on 1800 686 268 in Australia, the National Breastfeeding Helpline on 0300 100 0212 in the UK) — for any pain at every feed, cracked or bleeding nipples, or if you think your baby may have tongue-tie. The NHS notes cracked or bleeding nipples raise the risk of infection.
What's useful to note
Note which side hurts, when the pain starts (start of the feed, all through, or after), what your nipple looks like after feeds, and what you've tried. That makes it much quicker for a supporter or doctor to narrow down the cause.
