What causes nipple pain or damage?

·       Many causes - assessment is needed to identify cause.

·       Common causes of pain; poor attachment, issues with infants’ oral anatomy, bacterial infections, candida (thrush), herpes, vasospasm, eczema/dermatitis, white spots

General management:

·       Stimulate the milk-ejection before attaching the infant.

·       Small, frequent feeds to prevent engorgement.

·       Warm compress after feed.

·       If too painful, hand pump or express 24-48hr to allow healing.

·       Topical treatments; lanolin, hydrogel pads. Limited evidence but keeping nipple moist may assist in healing.

·       Nipple shields; can help short-term if the damage is moderate to severe. Protects the nipple during feeding. Can cause issues with returning to the breast.