278 Where There Is No Doctor 2011
Sore or Cracked Nipples
Sore or cracked nipples develop when the baby sucks only the nipple instead of
taking the nipple and part of the breast when she is breastfeeding.
Treatment:
It is important to keep breastfeeding the
baby even if it hurts. To avoid sore nipples,
breastfeed often, for as long as the baby
wants to suck, and be sure the baby is
taking as much of the breast into her mouth
as she can. It also helps to change the
baby’s position each time she nurses.
If only one nipple is sore, let the baby suck on the other side first, then let the baby
suck from the sore nipple. After the baby is finished, squeeze out a little milk and rub
the milk over the sore nipple. Let the milk dry before covering the nipple. The milk will
help the nipple heal. If the nipple oozes a lot of blood or pus, milk the breast by hand
until the nipple is healed.
Painful Breasts
Pain in the breast can be caused by a sore nipple or breasts that get very full and
hard. The pain will often go away in a day or two if the baby breastfeeds frequently and
the mother rests in bed and drinks lots of liquids. Usually, antibiotics are not needed,
but see the next section.
Breast Infection (Mastitis) and Abscess
Painful breasts and sore or cracked nipples can lead to an
infection or abscess (pocket of pus).
Signs:
• Part of the breast becomes hot, red, swollen, and very painful.
• Fever or chills.
• Lymph nodes in the armpit are often sore and swollen.
• A severe abscess sometimes bursts and drains pus.
Treatment:
♦ Keep breastfeeding frequently, giving the baby the infected breast first, or milk
the breast by hand, whichever is less painful.
♦ Rest and drink lots of liquids.
♦ Use hot compresses on the sore breast for 15 minutes before each feeding. Use
cold compresses on the sore breast between feedings to reduce pain.
♦ Gently massage the sore breast while the baby is nursing.
♦ Take acetaminophen (p. 379) for pain.
♦ Use an antibiotic. Dicloxacillin is the best antibiotic to use (p. 350). Take
500 mg. by mouth, 4 times each day, for a full 7 days. Erythromycin (p. 354) or
cotrimoxazole (p. 357) can also be used.
Prevention:
♦ Keep the nipples from cracking (see above) and don’t let the breasts get overfull.