Managing common breast concerns

Sore or cracked nipples are common for women who are starting breastfeeding. This fact sheet has some tips to help stop or manage this problem.

Sore nipples

Some nipple pain is normal at the start of feeds in the first 1 to 2 weeks. If it continues longer, it could be a sign that your baby is not attached to the breast correctly.

Here are some tips that may help to prevent pain:

• Wash your hands well before feeding.
• If you are using breast pads, change them often when they are damp.
• Soaps, lotions and shampoos can cause skin to dry out. Avoid using them on the nipples.
• To take your baby off your breast, carefully break the suction with your little finger in the corner of your baby's mouth.
• Let your nipples air dry after each feed.
• Try gently hand expressing if your nipples are too sore to breastfeed.

Cracked nipples

Cracked nipples can be painful but they often heal quickly. Cracked nipples are often caused by the baby not being attached to the breast right. If you have cracked nipples, it is best to get help from an Australian Breastfeeding Association counsellor or a breastfeeding-trained health professional.

Here are some tips:

• Follow the nipple care tips for sore nipples on this page.
• It is okay to not feed on the sore breast (for 12 to 24 hours) if it is too painful. You can express milk by hand during this time to feed your baby in a bottle or cup.
• If you use breast pads, remove them gently. If the pad sticks to the breast, express a little breastmilk to moisten it before trying again.

Swollen breasts

In the first week when your milk comes in, your breasts can feel full and firm (sometimes referred to as “engorgement”). This can also happen if you have been separated from your baby or have stopped breastfeeding suddenly. This will usually go away within a couple of days. Here are some tips to help reduce the fullness:

• Breastfeed your baby when they cue (signal) to feed (8 to 10 times or more in 24 hours). If you are separated from your baby, you will need to express as often as your baby would breastfeed.
• Make sure that baby is positioned and attached well at the breast and feeding is comfortable
• Try hand expressing a small amount of milk for your comfort before or after a feed. This will help to make the breast soft enough for your baby to attach.
• Gentle stroking (not firm massage) of your breasts gently during feeds.
• Allow your baby to completely empty the first breast before offering the other. Next time start on the other breast.
• Wear a supportive, well-fitting bra (no underwire). If you want to wear an underwire bra, it is important that you at least sleep without it on
• You might try applying some cool packs to reduce the discomfort.

If your breasts remain hard and uncomfortable for more than 24 hours or baby is unable to attach well at the breast, seek help from a breastfeeding trained professional.

Mastitis (inflammation of the breast)

Mastitis occurs when blocked milk ducts in your breast become inflamed or infected. Signs of mastitis can include swollen, hot and red breasts, and you may have flu-like symptoms. It is recommended that you see your doctor straight away. You may need antibiotics or pain relief to help manage mastitis. If you do not get medical help mastitis can lead to an abscess in your breast.

• It is important that milk is removed from the breast during this time. It is safe to continue to breastfeed your baby when you have mastitis.
• If it is too painful, you might try expressing breastmilk until the pain lessens.
• Follow the tips listed under “swollen breasts” section above.

For more information or assistance

In hospital

• Talk to a midwife or lactation consultant about any concerns you have.

At home

• Talk to your local child health nurse, a lactation consultant, an Australian Breastfeeding Association counsellor or doctor.

Telephone

• Call your local child health nurse (see Queensland Health, Community Child Health service in the White Pages).
• Call 13 HEALTH (13 43 25 84)—ask to speak to a child health nurse for 24-hour child health information and advice.
• Contact the Australian Breastfeeding Association:
  • call the 24-hour / 7-day free breastfeeding helpline from anywhere in Queensland on 1800-mum-2-mum (1800 686 2 686).
  • call the Queensland branch on (07) 3254 2233.

Websites

• Australian Breastfeeding Association

Resources for parents, families and carers

Booklet: Your guide to the first 12 months, Queensland Government (given to parents of every baby born in Queensland with the Personal Health Record)

Breastfeeding and your baby, Queensland Government

Healthdirect Australia—Breastfeeding, Australian Government

Raising Children Network—Grown-ups, Australian Government

Raising Children Network—Newborns nutrition, Australian Government

Raising Children Network—Breastfeeding videos, Australian Government

Booklet: Breastfeeding and postnatal care, New South Wales Government—available in English, Arabic, Chinese (Simplified), Chinese (Traditional), Farsi, Hindi, Korean, Punjabi and Tamil languages

Booklet: Breastfeeding your baby (PDF, 3.6MB), New South Wales Government

Fact sheet: Breastfeeding tips for new mothers (PDF, 111kB), New South Wales Government

Breastfeeding your baby, Victoria Government

Brochure: Breastfeeding (PDF, 1.35MB), Victoria Government

Baby care—weaning, Victoria Government

Breastfeeding, South Australia Government

Breastfeeding—Weaning from the breast, South Australia Government

Related content

Is my baby getting enough milk?

Common breastfeeding concerns: When do I stop breastfeeding?

Breastfeeding and drugs

Breastfeeding if you are away from your baby

Acknowledgements

This fact sheet is consistent with the National breastfeeding strategy 2010–2015.

Information is drawn from:

• Children's Health Queensland Hospital and Health Service 2015, Child health information: Your guide to the first 12 months.
• National Health and Medical Research Council 2012, Infant feeding guidelines.
• Preventative Health 2008, Growing Strong: Feeding you and your baby, Queensland Health.
• Preventative Health 2010, Breastfeeding and your baby, Queensland Health.
• Queensland Clinical Guidelines, 2023, Establishing breastfeeding.

This fact sheet is also the result of input and effort from many health professionals in Queensland. Their assistance with the content is greatly appreciated.
This information is provided as general information only and should not be relied upon as professional or medical advice. Professional and medical advice should be sought for particular health concerns or events. Best efforts have been used to develop this information, which is considered correct and current in accordance with accepted best practice in Queensland as at the date of production. The State of Queensland (Queensland Health) does not accept liability to any person for the information provided in this fact sheet nor does it warrant that the information will remain correct and current. The State of Queensland (Queensland Health) does not promote, endorse or create any association with any third party by publication or use of any references or terminology in this fact sheet.