One of the most common problems breastfeeding women experience is nipple pain. This usually occurs in the first few days after birth and is generally due to the way the baby is latching onto the breast. Although nipple pain is common, it’s not normal.

Breastfeeding is a learned art for both mother and baby. For most, it takes practice. Find a breastfeeding position (or a few) that you are comfortable in and baby is latching well. Ideally, this will be latching onto the breast (areola) tissue, not just the nipple. Once you both have learned this, breastfeeding should not be painful.

However, some mothers continue to have nipple pain beyond the first week of life despite correction of the latch. There are several different causes for this such as bacterial infections, dermatitis,   a high arched palate or an infant’s tongue which may have restricted movement, causing pain with breastfeeding.

One less common cause of nipple pain is Raynaud’s Syndrome or vasospasm of the nipple. Raynaud’s Syndrome is a condition in which the small blood vessels in the fingers and toes contract on exposure to cold. This causes a decrease in the blood flow and the tips of the fingers turn white and become painful. Once they start to warm up, the blood flows into them quickly, causing a red or purplish color and a throbbing pain. Finally, the normal flesh color returns and pain resolves. This can occur by itself or can be associated with a group of autoimmune disorders.

This same sequence of events can occur in the nipples of a breastfeeding woman. This may or may not be associated with classic Raynaud’s Syndrome. It can also be triggered by nipple damage, infection or by certain drugs. The pain will typically occur after the feeding and be associated with blanching of the nipple followed by a deep purple color and then a return of normal color. Pain is often worse with exposure to cold.

Dry heat placed on the nipples immediately after the baby comes off is usually effective. This can be done with wool breast pads or placing small hand warmers over a breast pad. Current research shows oral evening primrose oil may also be effective.