Australian Breastfeeding Association (ABA) counsellors are trained to provide breastfeeding support. They are mothers who want to help other women enjoy breastfeeding their babies. Many mothers have problems with their breasts. If you deal with these problems straight away you may stop them getting worse.

Here are some simple suggestions which can help. If you want more information or want to ask a question, ABA is nearby. All states have a counselling service and email counselling is also available. Counselling is free to anyone who needs help with breastfeeding. The telephone interpreter service could help you to talk to a breastfeeding counsellor. Our booklet Breast and nipple care also contains lots of valuable information. It is available from Mothers Direct.

Ante-natal | Sore Nipples | Cracked Nipples | Engorgement | Blocked Ducts | Mastitis

Ante-natal preparation

• ask your medical adviser to examine your breasts and nipples.
• check that your bra fits correctly as your breasts enlarge during pregnancy.
• do NOT use soap or anything drying (e.g. methylated spirits) on your nipples.
• avoid scrubbing with rough towels or brushes - gently pat breasts and nipples dry after showering or bathing.
• if you wish you may pull out your nipples and roll them gently between thumb and forefinger - should be done firmly but should not hurt.
• expose the breast area to air for short periods.

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To help relieve sore nipples

• Feed your baby often - don't put off feeds
• Before feeds:
  • Make yourself comfortable and relax, remembering your ante-natal exercises.
  • Massage your breasts gently.
  • Apply warmth to your breasts - warm shower, warm face washer.
  • Express some milk to soften the areola, to get the milk flowing and to lubricate the nipple. For pain relief, try applying a covered block of ice to the nipple, or ask your medical adviser about other alternatives.
• During feeds:
  • Offer the less sore side first.
  • Make sure baby is properly positioned at and attached to the breast. (See diagrams below, description of positioning in Increasing Your Supply Feature and refer to an ABA counsellor).
  • Try different feeding positions.
  • If you wish, restrict comfort sucking while nipples are tender. Gently break suction with clean finger before removing baby from the breast.
• After feeds:
  • Check your nipples for signs of stress.
  • Express a few drops of hindmilk and smear on the nipple. Leave your bra open for a few minutes until nipples are dry.
  • Keep nipples dry. Change nursing pads frequently. Consider washable nursing pads if disposable ones are chaffing.
  • Use breast shells or nipple protectors over tender nipples to stop clothes rubbing and allow air to circulate.
• Avoid:
  • Using anything on your nipples which is drying or which may damage nipple skin (e.g. tinct benz co., methylated spirits, soap, shampoo, harsh towels, toothbrushes, etc.).
  • Wearing poorly-fitted bras and plastic-backed nursing pads.
  • Using suction breast pumps.
  • Using nipple shields.
• See your medical adviser if soreness persists.

Diagram copyright Ros Escott.

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To help a cracked nipple

• Follow the suggestions for sore nipples while continuing to feed your baby particularly with regard to correct positioning and allowing air to circulate around your nipples.
• If it is too painful to feed, take the baby off the breast temporarily to rest the nipple and allow healing to begin.
• Express by hand (not pump) to keep the milk flowing and to keep up your supply.
• Feed the expressed milk to your baby.
• Start feeding again gradually, with short feeds spaced out during the day.
• See your medical adviser if healing is slow or you need pain relief.
• If all else fails try a nipple shield. (Use with supervision)
• Contact a lactation consultant, child health nurse or an ABA breastfeeding counsellor for further help.

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To relieve engorgement

• Feed your baby frequently from birth, without limiting sucking time.
• Take your bra off completely before beginning to breastfeed.
• Avoid giving other fluids.
• Wake your baby for a feed if your breasts become full and uncomfortable.
• Use warmth before feeds.
• Express a little before feeds if baby has trouble latching and staying on.
• Massage the breast gently while you are feeding.
• If necessary, express after feeds.
• Use cold packs after a feed to keep you feeling comfortable.
• Careful use of cool washed cabbage leaf compresses.
• Ask your medical adviser or hospital staff about pain relief if required.

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To help relieve blocked ducts

• Rest as much as possible.
• Keep the affected breast as empty as possible by feeding frequently.
• Apply warmth to the affected breast area before a feed.
• Feed from the affected breast first, when baby is sucking vigorously.
• Gently but firmly massage the lump toward the nipple during (and after) feeds.
• Massage the breast gently while baby feeds.
• Change feeding positions to help empty the breast.
• Hand express if necessary.
• Cold packs after a feed may help relieve pain.
• See your medical adviser if you cannot clear the lump in 12 hours, or sooner if you develop a fever or feel unwell.

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To relieve mastitis

• Follow all the suggestions for a blocked duct.
• Consult your medical adviser as soon as possible.
• Go to bed, if you can, and take your baby with you.
• Breastfeed frequently.

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