Answered by: Linda Jonides, R.N., C.P.N.P.
Question: Is it common for nipples to bleed when you start breastfeeding? Is there anything I can do to limit the pain and bleeding? Should I stop
breastfeeding? My son is 1 week old.
Answer: Please do not stop breastfeeding. Sore nipples and sometimes nipple cracking with bleeding can occur when you first start nursing. This can be due
to normal postpartum skin changes and/or improper latching on of your baby to the breast. As your milk supply gets established in the first few weeks, it's
very common for your breasts to feel engorged (filled with milk), which is uncomfortable for you and makes it more difficult for any baby to latch on
properly. When a baby is correctly positioned or "latched on," your nipple and much of the areola (the dark area around the nipple) are pulled well into
the baby's mouth. Your baby's lips and gums should be around the areola and not just tugging at your nipple. You might ask your spouse, a friend who has
breastfed, or your health care provider to observe you nursing to make sure your baby is latching on properly.
Until the cracking and bleeding are resolved, don't be alarmed if your baby spits up small amounts of blood or passes some blood in his bowel movements --
this is just because he may have swallowed some blood from your cracked nipples. This swallowed blood is not harmful to the baby.
Meanwhile, to manage the pain and bleeding, try to lessen the engorgement by expressing some milk, either by hand expressing or with a breast pump, before
the baby latches on to make it easier for him to latch on. You can also apply warm compresses or take a warm shower before nursing to soften the breasts.
Alternate your positions for feedings, and until your breasts heal you might want to start with the breast that is the least sore and limit the time on
that breast. You should continue to breastfeed frequently, 8 to 12 times per 24 hours, as this will prevent your baby from sucking too vigorously at each
feeding due to hunger. To promote skin healing, clean your breasts gently with a mild soap during your daily shower and rinse well. Then apply a pea-sized
portion of your breast milk or medical grade modified lanolin on your nipples to prevent dryness. Use non-plastic lined bras and/or bra pads, and change
the pads frequently. Try some relaxation techniques such as deep breathing or listening to soothing music before and during feedings to ease the
Please call your health care provider or lactation consultant if your nipples are not healing or feedings continue to be uncomfortable. Feedings should
become pleasurable for you and your baby. Breastfeeding your baby is one of the best things you can do for him. Good luck.