Soreness in the Beginning of Breastfeeding

Nipple tenderness at the beginning of a feeding may be normal in the first two to four days of breastfeeding. Soreness that is more intense or continues for a longer time indicates that some adjustment needs to be made.

Usually latch-on and positioning problems are the cause. Asking what area of the nipple is the sorest can give clues to the exact latch-on problem.

  • Soreness at the top of the nipple - indicates baby is not latched-on to enough breast tissue, or baby is raising up the back of the tongue while nursing (causing friction against the roof of baby’s mouth)
  • Soreness at the bottom of the nipple - may mean baby is sucking in his lower lip while nursing (encourage mom to simply pull it out!) or taking in too much of the upper top of the breast and not enough of the underside
  • Soreness at the tip of the nipple (with or without a horizontal red stripe) - this could be due to the breast not going deeply enough into baby’s mouth, the nipple pointing either up or down too much when latching on, tongue thrusting by the baby, or the baby having a short frenulum or short tongue
  • Soreness of the entire nipple - may be due to poor positioning/latch-on in a baby with a vigorous suck, the baby retracting his tongue during breastfeeding, or the baby curling up the tip of the tongue (which may produce a vertical red stripe on mom’s nipples after nursing). It may also be that mom is not breaking the suction when removing the baby from the breast, or even thrush could be the cause.