Sore Nipples & Breastfeeding

Reasons and Remedies for Nipple Soreness and Tender Breasts

Breast pumping should not be painful. Time-consuming? Sometimes. Challenging? Occasionally. Uncomfortable? Unfortunately, it can be – especially in the early days when becoming accustomed to the process. Remember, your breasts are still in the process of producing a consistent supply. So don’t worry, sore nipples happen when breastfeeding . However, breast pumping should never be painful.

If you’re experiencing nipple soreness or have painful nipples, treat it as a sign. Your body is telling you something. If you’re running a fever, your tender nipples are damaged, bleeding, and/or you suspect they are infected, please contact your doctor immediately. Set up an emergency consultation with a lactation consultant. Be proactive and get the treatment you need. Your health is of utmost importance, as your baby needs you.

Why do my nipples hurt?

First, consider the difference between ‘pain’ and ‘discomfort’. Every one of our “mothers in the know” remembers the initial days of breast pumping as “uncomfortable.” Thankfully, breast pump designs are continually updated to improve comfort and efficiency. Once you hit your groove the process should be comfortable, even relaxing. Nipple soreness should be a thing of the past.

If you’re dealing with nipple tenderness, following are some common reasons why this may be occurring as a result of breast pumping.  Each is accompanied by measures you can take to remedy the situation and heal your sore nipples.

Pump Settings Need Adjustment

If you’re still getting familiar with your breast pump you might need to adjust the pump settings. The recommended setting is usually the strongest comfortable suction. Many of today’s breast pump models feature a one-two minute introductory “letdown” phase. During this period your nipple is coaxed into a firmly erect position and then smoothly transitioned to a stronger suction phase for the remainder.

Flanges / Breastshields / Collection Cups Don’t Fit Properly

Breast pumps come standard with an average-sized flange. It’s probable this average size is not the right size for your nipples. If a flange presses too hard on your breast during pumping you could end up with blocked milk ducts and as a result, extremely sore nipples.

Also, if the flanges don’t fit properly you’re unlikely to fully empty your breasts while pumping, resulting in uncomfortable engorgement.

It’s nearly impossible to know which size flange best fits your breasts until you try them on during a pumping session and watch the nipple movement. If any of the following occur you will want to purchase a different size. 

You need a new size flange if:

  • Your nipple uncomfortably rubs the sides of the flange with the suction.
  • An excessive portion of the areola is pulled into the tunnel of the flange with suction.
  • You notice unusual redness after pumping from the pressure of the flange on your nipple.
  • Your nipple or areola turns white during and/or after pumping
  • You still have unexpressed milk after a full pumping session.  

Keep in mind you may need different sized flanges for each breast. Furthermore, your size is likely to change over the course of your pumping experience.

Damaged Nipples

Every woman’s body is different and nipple pain and skin sensitivity vary. In the early days of nipple pumping, most of our mothers-in-the-know experienced the pain of damaged or sore nipples during breastfeeding.

Primarily because we are overachievers – mistakenly thinking we needed to pump, pump, pump, and pump some more, to sufficiently establish our supply. Instead, be kind to your tender nipples and follow the personal pumping guidelines set by your physician and/or lactation consultant.

If you have damaged or extremely sore nipples due to over-pumping there are many options to soothe and heal them rather quickly.

  • Breast milk itself is a miraculous substance with countless nutritive, preventive, and healing properties. Directly following a pumping session do not dry the last drops of breast milk from your nipples. Comfortably massage the breast milk all over the nipple area.
  • Go topless directly after pumping whenever possible. A brief exposure to fresh air will help.
  • There are many quality options for soothing nipple cream. We suggest using something like pure lanolin, which doesn’t need to be washed and removed before pumping. This is important because additional washing and rubbing may intensify already present irritation. Apply creams as directed.
  • Breast shells or ice packs can fit into your bra and soothe your nipple pain, while protecting them from further irritation.
  • Apply nipple cream, extra breast milk, or olive oil inside the flanges before pumping to reduce friction.
  • One of our resident mothers-in-the-know swears by soaking her nipples in a small basin of salt water.

Infected Nipples

If damaged or sore nipples haven’t healed within a few days or if you notice a brief improvement followed only by worsened pain, you may have a nipple infection. An infection may be thrush (a yeast infection of the nipples) or bacterial. You need to consult your doctor to determine the cause of the infection and receive a prescribed treatment.

Beyond sore nipples, thrush symptoms may include:

  • Itchy or burning, painful nipples that appear pink or red, shiny, flaky, and/or have a rash with tiny blisters.
  • Cracked nipples.
  • Shooting pains in the breast during or after feedings.
  • Intense nipple or breast pain that is not improved with better latch-on and positioning.
  • Deep breast pain.

Again, consult your doctor right away if you experience any of these symptoms as thrush is easily spread and may be difficult to treat.

Engorged Breasts

When your breasts are engorged, they are full of milk and may feel big, hard, heavy and tender. The swelling usually affects both breasts at the same time and can stretch your nipples so that they’re flat. You may look flushed or feel slightly feverish.

This typically happens a few days after your baby’s birth, when your milk supply first arrives. However, your breasts may also become engorged if you are not fully emptying your breasts during pumping sessions. This could be due to aforementioned improper flange fit or otherwise.

The best thing to do for engorged breasts is to continue regularly nursing and pumping for 24-48 hours. Cabbage leaves and warm compresses will help to ease the discomfort. If your breasts stay engorged past this duration seek help from your physician and lactation consultant.


Mastitis is a severe inflammation of the breast, potentially due to infection. If you have mastitis you will generally feel like you have the flu; exhausted with all-over aches and pains. The affected breast will feel hard, hot, and painful with the skin appearing red. Mastitis may be infectious (in which case you will require antibiotics) or non-infectious as determined by your physician.

To relieve the resulting pain, keep your affected breast as empty as possible, pumping every 2 hours if possible. Get as much rest as you can. Hire help if necessary so you can stay in bed. Hydrate, warm your breasts with a soothing bath, shower, hot water bottle, etc. Avoid tight clothing and go topless for brief periods if possible. Strictly follow the treatment recommended by your physician.


Pumping milk can sometimes feel like an inconvenience. You may experience nipple pain when breastfeeding as you first adjust to pumping. But if you are experiencing pain or persistent discomfort it is always best to contact your physician. This article is not intended to treat or diagnose. Just know if you have nipple pain from breastfeeding or tender breasts, you are not alone. We’ve been there, as have many mothers when adjusting to a breast pumping regimen.

Do you have an experience you would like to share with us? A remedy not included above? Please let other mamas and friends know by publishing on our Facebook page. And don’t forget to share the amazing benefit of an insurance-covered breast pump from Byram Healthcare.


Daggett, Jennifer. How to Survive Pumping. 2013