How to Cope with Cracked, Bleeding, or Scabbed Nipples While Breastfeeding

Nipple fissures can be incredibly painful and may lead to complications like engorgement and mastitis. Understanding how to prevent and treat them is crucial for a more comfortable breastfeeding journey.

What Is Nipple Fissure?

Nipple fissures are painful cracks on the skin of the nipple, often affecting breastfeeding moms as their babies learn to nurse. Athletes like long-distance runners, surfers, and cyclists may also experience nipple fissures.

A nipple fissure can appear on one or both breasts, causing redness, soreness, dryness, and chafing. Though often temporary, it can make breastfeeding uncomfortable. If the condition worsens, nipples may bleed, develop sores, or scab, increasing the risk of engorgement, mastitis, and reduced milk supply.

Are Cracked or Bleeding Nipples Common When Breastfeeding?

Yes, cracked or bleeding nipples are a common issue for breastfeeding moms. Studies suggest that 80–90% of breastfeeding women experience nipple fissures.

If latching is painful, adjusting your baby’s latch can help prevent further damage. A lactation consultant or healthcare provider can provide guidance on positioning, feeding techniques, and healing strategies. In some cases, exclusive pumping for a few days may be necessary to allow the nipples to heal.

What Causes Nipple Fissures?

The most common cause of nipple fissures is a poor latch. If a baby does not get enough of the nipple and areola into their mouth, the friction can cause irritation, cracking, and bleeding.

Other causes include:

• Baby’s physical traits – Conditions like tongue-tie, a high palate, or difficulty opening the mouth wide may affect latching.
• Breast conditions – Flat or inverted nipples, engorgement, or swelling (edema) can make proper latching difficult.
• Improper breast pump use – Suction set too high or ill-fitting flanges can cause nipple trauma.
• Thrush (yeast infection) – Red, itchy, painful nipples with a burning sensation may indicate a yeast infection.
• Eczema or dry skin – Severe dryness can cause cracking and discomfort.

How to Treat Nipple Fissures While Breastfeeding

During Breastfeeding:

• Check your baby’s latch – Ensure a deep latch with the nipple far back in the baby’s mouth.
• Try different nursing positions – Laid-back breastfeeding may reduce nipple pain.
• Use a cold pack before feeding – This can help numb the area and ease discomfort.
• Breastfeed frequently – Nursing every 2–3 hours prevents engorgement, making latching easier.
• Pump before nursing if engorged – A hand pump for a minute can soften the nipple for better latching.
• Use reverse pressure softening – Gentle pressure around the nipple can help prepare for feeding.
• Start with the less-injured breast – Babies tend to nurse more gently on the second side.
• Pump instead of breastfeeding – If nursing is too painful, pumping may be a temporary alternative.
• Limit nursing duration – Listen for swallowing sounds; stop when the baby is no longer actively feeding.

After Breastfeeding:

• Detach baby gently – Break the suction with your pinky before removing your baby.
• Clean your nipples carefully – Rinse with warm water, pat dry, and air dry after each feeding.
• Apply a warm compress – A warm washcloth can soothe sore nipples.
• Use an antibacterial cream – If prescribed, apply as directed to prevent infection.
• Try lanolin cream – Safe for most moms, lanolin soothes and protects cracked nipples.
• Use expressed breast milk – Natural healing properties can ease irritation.
• Consider hydrogel dressings – These pads promote healing and provide soothing relief.
• Take pain relievers – Ibuprofen or acetaminophen can help manage pain.
• Wear breast shells – These create a barrier between the nipple and clothing, reducing irritation.
• Choose the right nursing bras – Soft, well-fitting, natural-fabric bras prevent additional irritation.
• Change nursing pads frequently – Dry nipples are less prone to infection.
• Use fragrance-free detergents – Avoiding chemicals and fragrances can reduce irritation.
• Consider LED therapy – This non-invasive treatment promotes healing and reduces pain.

When to Call a Doctor for Cracked or Bleeding Nipples

Seek medical attention if:

• A cracked nipple remains painful or bleeds for more than 24 hours.
• You have signs of infection like fever, pus, or severe inflammation.
• Your nipple appears shiny, flaky, or burns.
• You experience radiating nipple pain.
• Breastfeeding pain interferes with feeding your baby.

Is It Safe to Breastfeed with Cracked or Bleeding Nipples?

Yes, a baby swallowing small amounts of blood is not harmful. However, you should temporarily stop breastfeeding and consult a doctor if you have:

• Hepatitis C – The virus can be transmitted through infected blood.
• Toxoplasmosis – The parasite may pass through breastfeeding if your nipples are bleeding.

In such cases, continue pumping and discard the expressed milk to maintain supply.

By addressing nipple fissures early, you can minimize discomfort, prevent complications, and maintain a successful breastfeeding experience.