Cracked nipples while nursing

Cracked nipples during feeding very often occur in the first days after the birth of the child. For a woman, this is not just an unpleasant symptom: sometimes some young mothers are even forced to give up breastfeeding, as the pain becomes simply unbearable. However, not everything is so hopeless: cracked nipples can be both prevented and cured. We will try to tell you how to do this correctly in this article.

ICD 10 code

• O 00 – O 99 – Pregnancy, childbirth and postpartum period.
• O 85 – O 92 – Complications related to childbirth.
• O 92 - Other changes in the mammary gland and lactation disorders related to childbirth.
• O 92.1 - Cracks in nipple related to childbirth.

Causes of cracked nipples during feeding

What are the causes of cracks in the nipple area?

• Incorrect latching of the nipple by the baby during milk sucking. Correct latching implies complete latching of the nipple with the baby's mouth along with the areola. If the breast is not positioned correctly in relation to the baby, the areola is irritated, which inevitably leads to cracks.
• Forced termination of the act of feeding. When completing feeding, it is necessary to wait until the baby releases the nipple on his own. Otherwise, the child will try to hold it, thereby squeezing and damaging the skin of the areola.
• Lack of care for the mammary glands, or improper care: overdrying the nipples, excessive friction with a towel, frequent washing of the breasts with soap, etc.
• Individual hypersensitivity of the skin.
• Lack of vitamins in a nursing mother, which manifests itself in excessively dry skin.
• Incorrect use of a breast pump or hand expressing.
• Allergic reactions of the skin on the nipples to soap, shower gel, creams, etc.
• Constant use of breast pads, leakage of breast milk.
• Presence of teeth in a child.
• Treatment of nipples with alcohol and alcohol-containing products.

There can be many reasons for the appearance of cracks, and the pathogenesis of the disease is not always the same. In some cases, a woman can adhere to all the rules of feeding and caring for the mammary glands, but cracks still occur. The fact is that the provoking factors of damage to the nipples during feeding can be individual features of their structure. The shape of the nipples does not always correspond to the norm - they can be inverted, flat (the so-called "blind nipple"). The main thing is to pay attention to the problem in a timely manner and begin treatment.

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Symptoms of Cracked Nipples

The appearance of nipples when cracks occur is always characteristic. The first signs appear as small "cuts" on the skin of the nipple, from its central part to the outer edges of the areola.

Cracks appear either in large numbers, or from one to three in the field of vision; on one of the mammary glands, or on both at the same time (often it depends on which breast the baby is applied to more often). Pain during application depends on the depth of the cracks - superficial damage causes significantly less pain. A clear liquid may ooze from the wound, sometimes even with an admixture of blood.

Any manipulation of the nipple provokes sharp pain, especially the act of feeding the child. Often the pain becomes so unbearable that the woman has to stop breastfeeding and transfer the baby to formula.

If this condition is not treated, complications may arise: infection may occur - microbial, fungal or viral. The consequences of such complications are mastitis, inflammation in the nipples (usually purulent), the formation of erosions, ulcers, etc. In severe cases, surgical treatment may be necessary.

Diagnosis of cracked nipples during feeding

Diagnosis of cracks is quite simple. In the vast majority of cases, the diagnosis is made based on the following data:

• general examination of the breast - both the healthy mammary gland and the gland with damaged nipple skin;
• a survey about how the feeding and breast care process occurs, what kind of underwear is used, etc.;
• clarification of additional signs and symptoms.

If cracks appear on the nipples, as well as other problems associated with the mammary glands, you should consult with doctors such as a gynecologist or mammologist. If necessary, specialists will prescribe the necessary tests:

• general blood test, leukocyte formula (test for the presence of an inflammatory process);
• examination of nipple discharge.

Instrumental diagnostics for cracked nipples is rarely performed, but only for preventive purposes or if other concomitant diseases of the mammary glands are suspected. In such situations, the following is prescribed:

• ultrasound examination of the breast;
• mammography;
• RTM-study (microwave radiothermometry);
• electrical impedance tomography.

In difficult cases, a comprehensive examination of patients is used, with cytological and histological verification of the diagnosis. Differential diagnostics can be carried out with inflammation of the nipple of the mammary gland, as well as with a cancerous tumor. At the slightest suspicion of the development of a malignant process, the patient is prescribed all possible types of research in order to avoid an error in treatment.

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Treatment of cracked nipples during feeding

Cracked nipples are not a reason to stop breastfeeding and introduce formula to the baby. This will inevitably lead to the cessation of milk production and the baby's complete refusal of the breast.

If cracked nipples cause only minor discomfort, you can continue to breastfeed your baby, using preventive silicone or latex pads. Such devices can be purchased at pharmacies - they are produced by almost all well-known companies specializing in the production of breast pumps and other accessories for young mothers. These are brands such as Avent, Medela, Chicco, Conpol, etc. The pad is selected individually, taking into account the size of the breast and the size of the nipple.

If there are a large number of deep bleeding cracks, pads will most likely not help. In this case, milk should be expressed manually and fed to the baby, while simultaneously healing the damaged skin on the nipples.

If measures were not taken in time and mastitis developed, it is necessary to take into account that bacteria can also be transmitted to the child. In this case, breastfeeding is stopped.

What you absolutely must not do:

• wash nipples with soapy water and other alkaline solutions;
• apply antibiotic medications to the nipples, as well as take antibiotics orally;
• treat the breasts with alcohol solutions, including iodine or brilliant green;
• use breast pads for a long time, wear tight bras.

Cracks heal best if the breasts are open and there is access to air to the damaged nipples. Therefore, it is necessary to give up closed underwear for a while, and use breast pads as rarely as possible, or not at all.

The most popular ointments and creams for cracked nipples during feeding:

Products containing dexpanthenol – a healing component representing B vitamins:

• Bepanten (cream, ointment) 5% is applied one or several times a day;
• Dexpanthenol – used under a bandage or compress;
• Panthenol – apply several times a day, after feeding;
• Kornegel is used after feeding and washed off before putting the baby to the tray.

Preparations containing zinc oxide – an antiseptic substance with a drying and tanning effect:

• Zinc ointment - apply three times a day, remove before feeding;
• Zinc paste – used in the same way as zinc ointment;
• Tsindol – used 4-6 times a day on dry skin. Requires rinsing;
• Desitin - lubricate the nipples three times a day, washing off before feeding;
• Sudocrem - used several times a day, removing before applying to the baby.

External products containing lanolin, an animal lipid that provides skin protection:

• Purelan - lubricate nipples as needed;
• Sanosan – can be used after each feeding;
• Lanolin – used several times a day;
• MultiMom – lubricate the nipples until complete recovery;
• Karelan – used 3 times a day;
• Lanovit with sea buckthorn oil is a safe drug that can be used without restrictions.

Medicines containing retinol (vit. A), which effectively restores damaged skin:

• Videstim - applied twice a day;
• Retinoic ointment - used during the day;
• Radevit - applied twice a day, can be applied under a bandage;
• Retinol acetate - lubricate the skin as needed.

Herbal and mineral ointments:

• Vulnusan - lubricate the nipples with a thick layer several times a day;
• “9 months” (Mustela) – use 2 times a day until complete recovery.

Anti-inflammatory drugs:

• Solcoseryl - lubricate the affected juices three times a day;
• Actovegin - apply under a compress three times a day.

Other remedies for cracked nipples during breastfeeding:

• Sea buckthorn oil is a natural product, harmless and effective. Softens the skin and promotes rapid healing. Does not require rinsing. •
• Rosehip oil – relieves signs of inflammation (due to the content of vitamin C). Apply immediately after feeding. No need to wash off. •
• Vitamin E oil solution – restores and heals the nipple area. •
• Chlorophyllipt (oil-based) is an excellent antiseptic, eliminates the symptoms of the inflammatory process. It must be washed off before feeding. •
• Calendula ointment - heals cracks, destroys bacteria. Wash off before feeding.

Folk remedies for cracked nipples

Often, treatment with herbs and other folk remedies has a good effect. Such recipes are passed down from generation to generation, from one mother to another. When there is no opportunity to go to the pharmacy, the following remedies can come to the rescue:

• Lubricate the nipples with castor oil. After each application, keep the breast open for at least 10 minutes.
• Apply melted butter to the nipple area for 2-3 days.
• Lubricate the areola area with brilliant green, then apply a layer of Vaseline several times over the course of 3 days.
• Apply a compress of finely grated apple 2-3 times a day. You can make a mixture of grated apple and butter, or carrot juice.
• Apply a paste of boiled flax seeds to your chest.
• Lubricate the nipples with fresh aloe or kalanchoe juice. Before feeding, the juice should be thoroughly washed off.
• Apply fresh natural honey to the nipple area and wash it off with warm water after half an hour.
• Apply a cabbage leaf to the damaged skin, slightly beaten with a hammer (to release juice). This remedy is recommended to be used at night.

Homeopathy for Cracked Nipples

Many patients trust such a popular method of treatment as homeopathy. For the treatment of cracked nipples, there are also certain homeopathic preparations, both for internal use and for external use.

Homeopathic remedies for internal use:

• Graphites 3C and Arnica 3C – 5 granules sublingually, 20 minutes before feeding;
• Acidum Nitricum 6C – for severe pain;
• Ratanya 3C – for itchy cracks;
• Croton tiglium 3C – for severe girdle pain;
• Sulfur - for deep skin lesions with bleeding;
• Petroleum - for cracks with crusts and plaque.

Local homeopathic remedies:

• Arnica – dilute 5 drops in 200 ml of drinking water and moisten the nipples after each feeding;
• Chamomile (Camomilla) – used in the same way as Arnica.

In advanced cases, washing the nipples with Borax tincture may help: use 5 drops per 200 ml of water.

Preventing cracked nipples during feeding

Prevention of cracks should primarily include proper positioning of the baby during feeding, in combination with compliance with the rules of hygiene and care of the mammary glands.

Even while carrying a child, it is necessary to prepare the breast for feeding:

• regularly take a contrast shower, wash your chest alternately with hot and cool water;
• gently massage the areola area;
• apply a nourishing and moisturizing cream to the mammary glands;
• use regular soap to wash your breasts less often (no more than once a week);
• Avoid wearing tight and dense underwear, as well as bras made of synthetic fabric.

At the very beginning of the lactation period, it is recommended to adhere to the following rules:

• You should not wash your breasts with soap often, and you should not leave your nipples wet;
• It is not advisable to use alcohol-based lotions and solutions to treat the breasts, as alcohol dries the skin and washes away the natural protective barrier on the nipples;
• You cannot forcefully wean your baby from the breast: you must wait until he releases the nipple on his own;
• It is important to ventilate the mammary glands as often as possible.

The question arises: how to properly position the baby for feeding so that cracks do not form on the nipples?

1. Before feeding the baby, it should be half-turned with the body towards the mother. It is wrong if only the baby's head is turned towards the breast. The best position for feeding is when the mother lies on her side, and the baby's tummy is adjacent to the mother's tummy.
2. It is desirable for the baby's head to be located on the inside of the mother's elbow: this way it is easier for him to move while sucking.
3. You should not force the nipple into the baby's mouth: he will latch on to the breast himself.
4. It is correct if the baby grasps not only the nipple, but also the areola (area around the nipple). In this case, the baby's nose should be pressed against the mammary gland.

If everything is done correctly, the risk of cracks will be minimized.

Forecast

If cracks in the nipples are treated correctly and competently, the prognosis is considered favorable. Otherwise, complications in the form of mastitis and inflammation of the nipple are possible, often with the addition of a purulent process.

Cracked nipples during feeding should not be the reason for the end of the lactation period. Immediately after the condition improves, breastfeeding should be resumed.