Q

When my nursing baby comes off my breast I notice a stripe across my nipple (slightly whitened) and the nipple appears slightly compressed. I am having a bit of pain while nursing. Why does this happen? Do you think there is a problem?


A

The type of nipple pain and appearance you describe is not a normal or expected part of breastfeeding. (Newman & Pitman 2000) Any soreness that lasts past the baby's tenth day of life or causes breaks or cracks in the skin is considered to be pathologic, or abnormal and is often caused by poor position and latch. (Huml & Riordan 1995)

The most common cause of nipple pain when associated with a visible compression stripe is a shallow latch, meaning the baby has not taken in a large enough mouthful of the breast while latching. ( Mohrbacher & Stock 1997) (Newman & Pitman 2000) This is evident to most lactation consultants based on their experience of being able to relieve this type of pain and physical appearance of the nipple with improved position and latch (Jones 1999) (Newman & Pitman 2000) When a baby has a good deep latch the lips are widely flanged with only a very slight angle at the corner of the lips. If the baby's lips appear to be "kissing" the breast or puckered that can indicate a shallow latch. The best way to ensure a deep latch is to wait until the baby opens very wide, like a big yawn, before allowing the baby to latch.

A shallow latch can also be an indicator of other breastfeeding concerns and can sometimes inhibit the baby's ability to get milk from the breast efficiently. Therefore, it is important to address this concern as soon as possible with a board certified lactation consultant for a complete evaluation of your breastfeeding situation.. The good news is that this type of breastfeeding concern frequently responds very quickly with some simple changes in your technique.

References:

  • "Sore Nipples: Looking at an Old Problem in a New Way" Huml, S. & J. Riordan, La Leche League International Conference, July 1995.
  • "Considering the Evidence: What Does the Literature Tell Us?. Sore Nipples: Do we really know what helps?" Jones, F International Lactation Consultant's Conference, Washington DC, July 29, 2000
  • The Breastfeeding Answer Book, Mohrbacher, N. & J. Stock, La Leche League International, Schaumburg, Illinois 389, 1997.
  • Dr. Jack Newman's Guide to Breastfeeding, Newman, J. and T. Pitman, HarperCollins, 98-100, 2000.