Chapter 16: Breastfeeding
Sore or cracked nipples
If a woman feels pain in her nipples while breastfeeding, the
baby is probably not in a good position. If the baby keeps
breastfeeding in a bad position, the mother’s nipples may
crack. Cracked nipples can become infected.
To treat sore or cracked nipples:
• Help the mother hold the baby in a position
that allows the baby to get a large mouthful
of breast (see page 282).
• The mother can rub breast milk into her
nipple. This will prevent infection in the
cracks and keep the nipples soft so they will
not crack more.
• Encourage the mother to leave her breasts
open to air and sunlight when she is not
• Encourage the mother to keep feeding from
both breasts — but she can start with the
less sore breast and switch to the cracked
one once the milk starts flowing.
Offer the whole breast (not
just the nipple) so the baby
can get a good mouthful.
• If the pain is too great to breastfeed, the mother can remove her milk by hand
and feed the baby with a cup and spoon for a few days.
If a baby is in a good position while suckling and the mother still has pain in the
nipples that lasts for more than a week, it may be caused by thrush (a yeast infection
on the nipple or in the baby’s mouth). The mother may feel an itch on her nipples or
a stabbing burning pain. The baby may have white spots or redness in her mouth.
How to treat thrush
Mix gentian violet and water to make a 0.25% strength. For example, if you
have a solution of 1% gentian violet, mix 1 teaspoon with 3 teaspoons of
Use a clean cloth or a finger to paint the nipples and white spots in the
baby’s mouth once a day for 5 days. Gentian violet will stain clothing and
will turn the baby’s mouth and the mother’s nipples purple — this is normal.
The mother should keep breastfeeding. If the thrush does not get better in
3 days, stop using gentian violet and get medical advice.
A Book for Midwives (2010)