Caring for Sore or Damaged Nipples

Breastfeeding is often described as natural and beautiful—but if you’re dealing with sore or damaged nipples, it can feel anything but. You’re not alone: many parents experience nipple pain in the early weeks. While mild tenderness can be normal, ongoing soreness or cracks deserve attention and care.

Why Nipples Get Sore

The first step in resolving nipple pain is identifying the underlying cause. Common culprits include an ineffective latch or feeding position, and poorly fitting pump flanges. Other issues include tongue tie, infections, or skin conditions. You don’t have to figure it out all alone - a skilled lactation consultant can help assess and correct these issues.

Relief from Nipple Pain

While you're investigating the cause, you still need pain relief. Unfortunately, research on nipple healing is often conflicting and there is not one accepted best practice. The strategies below combine available evidence with what I and my colleagues have seen work well for many families.

• Keep Things Clean

  • Wash your nipple area once or twice a day with mild soap and water—usually just during your regular shower. No harsh scrubbing.

  • If the skin is broken, rinse with tap water or saline after nursing to reduce infection risk.

  • Always wash your hands before applying any treatments.

• Make Feeding More Comfortable

  • Aim for a deep latch at every feed.

  • Start on the less sore side: Babies may latch more gently after they’ve already been feeding.

  • Express a little milk first: Getting milk flowing before latching can make nursing more comfortable.

  • Switch positions: Changing your baby’s angle or position may relieve pressure on sore spots.

• Comfort Measures for Sore Nipples

  There’s no single proven method to speed healing, but many parents find the following options helpful.

  Always follow the manufacturer’s instructions for any product.

• Breastmilk

  Your own breastmilk has natural soothing and protective properties. After feeding, hand-express a drop or two onto your nipples and let them air dry.

• Medihoney Paste (Medical-Grade Honey)

  Medihoney has antibacterial and wound-healing properties. It is medical-grade honey that has been treated to eliminate bacteria and botulism spores, making it safe for babies - don’t use regular honey. There are no specific studies on Medihoney use during breastfeeding, but it has been widely studied and found to be effective at treating other types of wounds. Some users report a slight stinging sensation upon application. Don’t use if allergic to honey or bees.

  How to use:

  • After nursing, gently rinse the nipple with water.

  • Apply Medihoney to the nipple.

  • Cover with a nursing pad.

  • Rinse or gently dab with a warm washcloth before the next feed.

  More info: 

  • Manufacturer's instructions

  • Information on Medical Grade Honey from the Infant Risk Center

• Commercial Nipple Balms

  Some parents find relief with commercially prepared ointments, especially those containing calendula, a plant known for its anti-inflammatory and healing properties.

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• Comfort Measures to Consider With Caution

  The following treatments have been effective for some people and there are studies supporting their use for nipple healing, but there are also some risks to consider.

• Hydrogel Dressings (Gel Pads)

  Worn over the nipples between feeds. Do not combine these with other ointments as it can render them ineffective or increase the risk of infection.

  • Pros: 

    • Soothing

    • Prevent wounds from sticking to bras/clothing

    • May support moist wound healing

    • Can be chilled for added relief

  • Cons: 

    • Can stick to wounds (if this happens—flush with water before removing)

    • Some studies show they may increase risk of infection

    • Should be avoided if you already have an infection, and used cautiously if you have Raynaud’s syndrome (the cooling sensation may trigger vasospasm)

  
  

• Silver Cups

  Small silver discs worn over the nipples between feeds.

  • Pros: 

    • One small study suggests they may speed healing.

    • May reduce bacterial growth. For antibacterial effects, skin must contact the silver directly—don’t combine silver cups with ointments because they create a barrier between the skin and the silver.

  • Cons: 

    • May cause tissue breakdown if worn continuously. Use intermittently and keep the area dry between uses.

• Approaches I Usually Avoid

• All-Purpose Nipple Ointment (APNO): 

  Contains an anti-fungal, antibiotic, and steroid. While effective for some, it’s very broad—considered by many to be too broad (overkill). It’s expensive, prescription-only (needs to be filled at a compounding pharmacy), and is intended for very short-term use due to the high potency of the ingredients.

• Lanolin: 

  Popular for nipple pain for years, it has likely been considered effective because of its hydrating properties. However, lanolin can be a skin irritant for some people and should definitely be avoided if you have a wool allergy.

When to Seek Professional Help

Be sure to call your healthcare provider promptly if you notice any signs of infection, such as:

• Increasing redness, swelling, or warmth

• Pus or drainage

• Fever or flu-like symptoms

If your nipples remain painful or aren’t healing after trying these measures, it’s time to reach out for lactation support. You don't have to tough it out. Sore nipples are a signal that something needs attention—whether it’s positioning, latch, flange sizing, or another factor. Getting the right help can make all the difference.

If nipple pain isn’t improving, I’m here to support you. Together we can find the cause, help you heal, and make feeding more comfortable for you and your baby.

Book an appointment here.

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