Sore Nipple Strategies

2019-08-17T22:50:34+00:00August 17th, 2019|Categories: Fertility Blog|Tags: , , , |

.Most of us had an idea in our head about how breastfeeding would go. You probably pictured the serene moments gazing into each other’s eyes, then your milk drunk baby slipping off to sleep in your arms.  The reality of the early days of breastfeeding can be surprising, as those of us that have lived them can attest. For 80-90% of moms, nipple and breast pain is part of their new mom life, at least in the short term since almost all nipple pain resolves in the first 2 weeks.

Nipple pain it’s not just for new moms, it can re-emerge with each baby. Issues like a shallow latch, slow let-down and tongue tie are unique to each baby. Although your breastfeeding experience will help you solve these problems much faster the second time around.

If you are suffering from nipple pain, here is a list of possible reasons and solutions:

-Shallow latch. You baby should have a wide open mouth before latching onto the nipple and surrounding areola, not just the nipple. Top and bottom lips should both be curled back and the chin firmly pressed on the breast. This position allows the nose to remain unobstructed with correct positioning.

– Pulling your baby off before breaking suction. When you are ready to take your baby off the breast, place a finger in the side of the mouth to release the suction first. Otherwise you stretch and strain tender nipple tissue.

-Slow milk flow. Your baby may be spending extra time on your breast or try to suck with greater force if your let-down reflex takes a while. To speed it up, self express a bit of milk before feeding to get milk flowing and soften up your breast before latching your baby. Once your baby is on the breast, use breast compression to keep milk flowing quickly without much suction from your baby.

-Using the same breastfeeding position every time. Depending on the angle, you baby’s mouth can apply pressure in different parts of your breast and nipple. If you have a tender spot when using the football hold, try lying on your side next time you feed.

-Dry, cracked nipple tissue. Your nipple has natural lubrication from the oils released by your Montgomery Glands, the little bumps that surround your areola. But the friction of your baby’s mouth can strip away your natural oils leaving your nipples red and cracked. There are several nipple creams available that can help your tender tissue heal. Check out our Milkies Nipple Nurture Balm  for an organic olive oil based cream that doesn’t need to be removed prior to putting your baby to breast.

Your nipple pain should taper off and go away entirely by day 14. If your nipple pain lasts longer or is accompanied by other breastfeeding problems like full breasts or a frequently fussy baby, see your lactation consultant.


Breast Anatomy Beyond the Nipple

2019-07-18T13:29:10+00:00July 18th, 2019|Categories: Fertility Blog|Tags: , , , , |

The internal structures of breasts were first described in 1840 by Sir Astley Cooper. And since then, our knowledge of breasts has changed to include many more than Cooper could have visualized. He described the breast being composed of glandular and adipose (fat) tissue held together by a loose framework of fibers he called Cooper’s ligaments (of course). Cooper’s ligaments support the structure of our breasts and are blamed for stretching during pregnancy and breastfeeding, leading to sagging. If you are interested, there are several exercises that claim to strengthen Cooper’s ligaments. I reviewed them and it appears they work the pectoral muscles (push ups, chest flys and chest press) which lay under your breasts. Working out your pectoral muscles helps your posture but is unlikely to have an impact on the connective tissue inside the breast.


Beyond the ligaments, the inside of a breast is an amazingly complicated structure. Surrounding the nipple like daisy petals are 15 to 20 sections, or lobes. Inside these lobes are smaller sections, called lobules that are arranged in clusters, like grape bunches. At the end of each lobule are tiny “bulbs” that produce milk. The bulbs are called alveoli and that’s where the magic of milk production occurs. From the alveoli,your milk enters the ducts, the thin tubes that carry the milk from the lobules to the nipple. When the milk-ejection reflex occurs, small muscles around the alveoli are squeezing the milk out into the lobules to the ducts and out of the nipples.


Imagine a stalk of broccoli and the tiny flower bits are the alveoli, the stem is the ducts which carry the milk to the nipple. Fat fills the spaces between the lobes and ducts. Actually, most of our breast volume is fat. When you shop for a bra, your cup size is mostly determined by how much fat you have between your connective tissue. That’s why your cup size has no relation to your ability to breastfeed. Smaller breasts (A to C cups) can be easier for babies to latch on, especially in the first days of life.


Working our way out of the breast, the last stop is the nipple. The nipple is in the center of a dark area of skin called the areola. The areola contains small glands that lubricate the nipple during breastfeeding. The bumps on the perimeter of your nipple are glands called Montgomery glands. They constantly secret oil to keep your areola and nipple healthy and moisturized. Montgomery glands also secret your unique scent that attracts your baby to the nipple and helps initiate breastfeeding. We have 12-14 openings in each nipple, and they can spray in any direction as anyone that his squirted milk in unpredictable directions knows.


A rough beginning but a happy ending – the conclusion

2014-12-17T20:37:36+00:00December 17th, 2014|Categories: Fertility Blog|Tags: , , , , , , |

Lauren was born in August and the days were warm and still. I felt relatively well and especially grateful to not be pregnant anymore in this hot weather. Lauren was breastfeeding around the clock and my older boys were busy with outside activities.

The nipple pain started on day two. Lauren always had a shallow latch but I kept working with her to take more breast tissue, enough that her top and bottom lips would curl over. I tried the positioning technique I learned from Dr. Newman – pulling her belly button in close and keeping her head aligned with her little body. It seemed like a natural way to hold her; she seemed comfortable and swallowed easily. Her latch remained shallow although I tried everything – pumping before feeding, holding the breast to make it the size of her mouth and waiting for the wide open mouth before putting her to breast. Nothing helped.

The nipple pain continued and they were bloody and cracked by day 3. Each time I fed Lauren I tried to get more breast tissue into her mouth and deepen her latch, but she would always slip down, causing pain with each feeding. Making matters worse, Lauren was not emptying the breast well with her shallow latch and she would often become frustrated, crying inconsolably. Oh the early days with a newborn – it is a tough time mommies!

Near the middle of day 3 I tried breast compressions as Dr. Newman had taught in his seminar. The technique is simple and easy to master. Place the hand on the breast the baby is nursing on and gently squeeze or push down on the ducts which are located above the areola. More milk is pushed down into the baby’s mouth than by suckling alone. This helps baby get full and mom’s body gets the signal to produce more milk. A win-win situation.

Day 4 and 5 we turned a corner and things got easier. I was using breast compression at every feeding; Lauren was growing bigger and stronger. As her mouth grew she was able to take more breast tissue into her mouth and my nipple pain subsided. She was still fussy in the evening, but soon she outgrew that too.

My early days with Lauren reminded me that each baby is different. Although I had breastfed before, Lauren hadn’t. It took us almost a week to learn this new skill. I was grateful to have a toolbox of interventions to try, since nothing seemed to work in the beginning. I also had the experience of successfully breastfeeding my other kids; I believed I would eventually be successful with Lauren too. Sometimes things just get better with time and experience. When the photo at the top of this post was taken, Lauren was 7 weeks and already traveling with me to talk about Milkies. She is showing a hunger cue I got to know well – sucking on her fist.

I also give credit to Dr. Newman. He has worked with thousands of mom and baby pairs and gives practical, easy-to-follow advice that worked very well for Lauren and I and so many others.

Here is the link to his website again.