The most common reason for nipple pain is due to a baby not attaching well to your breast. You may find it helpful to contact one of our trained breastfeeding counsellors on the Breastfeeding Helpline 1800 686 268 (1800 mum 2 mum) and/or refer to our article on attachment.
Nipple infection, as a possible cause of nipple pain, must be considered especially when:
- a breastfeeding mother experiences nipple pain beyond the first week or after a period of comfortable feeding
- her baby is attaching well to her breast
- other causes of nipple pain/trauma have been ruled out (eg tongue tie).
About 10% of breastfeeding mothers experience nipple/breast pain (not associated with breast redness or fever) that is often described as one or more of the following: ‘burning’, ‘stabbing’, ‘knife-like’, ‘shooting’, ’sharp’.
Sometimes it can be difficult to determine what bug is causing the nipple pain as different bugs can cause similar signs and symptoms. Is it:
- thrush (ie due to the bug Candida albicans) or
- a bacterial infection (ie due to the bug Staphylococcus aureus), or
- is it due to multiple bugs? (1)
Signs of infection on the nipples may include:
- shiny areas
- pus-like fluid or clear fluid coming from the nipple
There may be no outward signs.
Symptoms may include:
- sore nipples that are extremely sensitive (especially to light touch)
- knife-like or burning pain
- deep pain or throbbing within the breast
- pain sometimes extending to the arm or back
- pain often beginning during a feed and staying for some time afterwards.
If you have any of these signs or symptoms, see your medical adviser for diagnosis and treatment. One common treatment is a combined antifungal/antibacterial cream. In more severe cases, you may need to take tablets. Your medical adviser will also exclude other causes of similar symptoms to infections, such as dermatitis.
For more information, see:
ABA's booklet Breastfeeding: breast and nipple care
The Royal Women's hospital Breast and Nipple Thrush clincial practice guideline
The Royal Women's hospital Breast and Nipple Thrush article
- Amir LH, Cullinane M, Garland SM, Tabrizi SN, Donat SM, Bennett CM et al, 2011, The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol, Biomedical Central Pregnancy and Childbirth, 11(54): 1–10.
© Australian Breastfeeding Association January 2014
The information on this website does not replace advice from your health care providers.