Nipple issues are common in lactation. One of the most common issues experienced is nipple pain or problems with their nipples when pumping and breast/chest-feeding. Keep reading below to find out a few of the most common nipple issues and what to do about them!

Common nipple issues

There are so many things that I wish I would have known beforehand especially when it came to breastfeeding and pumping. First of all it is HARD and does not come naturally for most of us, secondly, there are so many common nipple issues I had never heard of, even as a NICU nurse.

To successfully breast/chest-feed or pump there is a lot that has to be coordinated and if one thing is out of whack, the whole process goes haywire.

Your nipples are a VITAL part of the system! One of the most common issues women experience is nipple pain or problems with their nipples when pumping and breast/chest-feeding.

I experienced several issues throughout my feeding journeys; exclusively pumping (EP) with twins and nursing my singleton.

Here are a few of the most common nipple issues that can occur and what to do about them!

Elastic nipples

YES, this is a thing! Another common nipple issue is elastic nipple tissue.

Imagine a wad of chewing gum being stretched and compressed over and over again. That is what it looks like when you are pumping with elastic nipples.

I experienced this when I was exclusively pumping for the twins. Your nipples and some of your areola get pulled into the flange. I never knew it was possible for them to stretch so far they could touch the end of the longest flange I could get my hands on!!

It can be painful, cause nipple damage, and lead ineffective pumping/output if not managed properly.

What causes this?

Some elasticity is normal! Typically occurs with pumping and the repetitive stretching of the skin mixed with hormones causes the over elasticity of your nipples.

What do to about it?

Sometimes getting a different size/brand flange (try Pumpin Pals, Medela flange, Spectra flange) or with a longer tubular part can help. Using breast cushions such as BeauGen is key! These BeauGen cushions hold your breast tissue and areola back, so only your nipple is being drawn into the flange. They do need to be replaced with normal wear. Elastic nipples usually do not affect directly latching/nursing. Schedule a consult with us and we can help you get the right flange sizing and cushions. We love the Silverette nursing cups with natural antimicrobial properties to help heal cracked, scabbed nipples.

Raynaud’s Syndrome

You may have heard of this before because some people have this in their hands or feet. It is a condition that causes arterial spasms in your nipples causing them to turn bright white and not allowing blood to flow to the tips of your nipples.

It is extremely painful and it is worse if it is cold outside. I also had the joys of experiencing this condition while exclusively pumping for the twins (the things we do for these babes!!)

Your nipples are sore and tender as it is and this amplifies the feeling 10 fold…mega OUCH!

What causes this? Researchers are not quite sure what causes Raynaud’s syndrome in the nipple. It is an over reaction of the blood vessels within your tissues in response to cold temperatures or stress. Read more about it here.

What to do about it? Management is the only option. Heat is your friend. I would walk around, even in public with heating pads on my breasts because it was the only thing that made me not want to cry!

This can occur with pumping or nursing. Turn up the heat in your house or in the room you are nursing or pumping!

Try these breast heating pads, breast gel packs that heat up or these breast shells to protect your skin.

Milk bleb

This is super common and is a little blister of milk on the tip of your nipple that can occur with nursing or pumping. Usually this is an indication of a blocked milk duct so you may feel a lump in your breast if you notice one of these.

What causes it? Milk that is not fully emptying the milk duct.

What to do about it? Apply warm wet compress before nursing or pumping, soak your nipple in warm water, hand massage your breast in an attempt to relieve the blockage.

A thick string of milk may come from the duct. Try these breast heating pads too!

Misshapen nipples

Not every nipple is created equal and not every nipple is ideal for nursing a baby. This is a tricky one and can cause major feeding issues and pain but also is a result of genetics so sometimes there isn’t much we can do to fix it.

Sometimes nipples can be flat, short or inverted causing latching issues. This can even be the case for just one side. Have you seen our nipple shield post? It’s helpful for different shape nipples and *spoiler alert*: there’s nothing wrong with using a nipple shield!

What causes it? Genetics or if you have had breast surgery sometimes nipple shape can be affected.

What to do about it: Make sure you get lactation help right away to assess and learn how to get a proper latch. Nipple shields, breast shells and nipple everters can also be helpful! Using techniques to elongate the nipple are essential to a good latch. Check out our nipple shield post for in depth information on nipple shields, when to use, and when to wean.

TIP: Try pumping or using a haakaa prior to nursing to evert your nipple!

Thrush

You may have heard of this being in your babies mouth, but if you are nursing it can be on your nipples as well. Thrush is a yeast infection on your nipple.

This infection causes MAJOR glass shard type pain your nipples and they turn bright pink/red in color. Your nipples could also be cracked, itchy, or burning.

What causes it? Yeast – which is found naturally on our skin. When normal flora (bacteria etc.) are out of balance, yeast will grow.

What to do? Call your provider for medication, such All Purpose Nipple Ointment and possibly oral antifungals. Manage the pain with OTC medications. Your baby will also need medication because it is likely they have thrush in their mouth from contact. If you are pumping, make sure to sterilize your pump parts, bottles, haakaa, etc.

Products: We love the Silverette nursing cups with natural antimicrobial/anti-fungal properties to help heal cracked, scabbed nipples. Cooling pads: same as heating pads above because you want it to cover the nipple.

photo sources: image 1, image 2

Have more questions? Schedule a text or video chat consult with Kate, Lauren or Natalie (NICU RNs) and they can help answer any questions that you have!

Other helpful blog posts:

Download our free nipple ruler to make sure you’re using the correct flange size.

Are you exclusively pumping? Download our free exclusive pumping sample schedules for 0-12 months of age.

**This post is educational and not meant to take the place of your provider. Bumblebaby makes a small commission on some of the items listed above

5 common nipple issues

Common nipple issues