Sore Nipples While Breastfeeding
Pain is common, but it is not something to push through.
Some tenderness in the first days is common. Pain that is severe, lasting, or with cracks and bleeding is a sign that something needs fixing. Here are common causes, what to try first, and when a prescriber-ordered ointment may be considered.
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- First step
- Have your latch and positioning checked by a lactation consultant, nurse or midwife.
- Call promptly
- Fever, a red hard painful area, pus, or flu-like symptoms.
- Who prescribes
- Your family doctor, nurse practitioner, midwife or other prescriber.
Why nipples get sore
The most common cause of nipple pain is a shallow latch or a positioning problem. Other causes include a baby’s tongue-tie, a fast milk flow, pump flanges that do not fit, and skin conditions such as dermatitis. Infection with yeast (thrush) or bacteria can cause burning, deep breast pain or cracked skin that does not heal. Nipple vasospasm, where blood vessels narrow, causes blanching and sharp pain after feeds.
Because the causes differ, the treatments differ. A cream cannot fix a poor latch, and a latch fix will not clear an infection. That is why a proper assessment matters.
Call a doctor or midwife promptly if you have a fever, a red, hot, wedge-shaped area on the breast, pus, or flu-like aches. These can be signs of mastitis or infection.
What to try first
- Get help with latch. Ask your midwife, public health nurse or a lactation consultant to watch a feed. In Ontario, local public health units, Health811 (dial 811) and the Breastfeeding Committee for Canada can point you to support.
- Break suction before removing the baby by slipping a clean finger into the corner of the mouth.
- Air-dry and avoid irritants. Skip scented soaps, and change damp breast pads promptly.
- Check pump fit if you pump: flange size matters.
- Ask about pain relief that is safe in breastfeeding. A pharmacist can check what you are taking.
When a prescriber may order a nipple ointment
If nipples are cracked, painful and not healing, or if an infection is suspected, a prescriber may order an all-purpose nipple ointment (APNO). It is a compounded preparation that typically combines more than one type of medicine in a single ointment, with the exact formula chosen by your prescriber. It is not sold over the counter and is only made with a prescription.
We prepare each ointment in our Level C compounding room and explain how much to use, when to apply it, whether to wipe it off before feeds, and how long to use it. Follow the directions on your label and your prescriber’s advice. Read more on our APNO page.
Safe use while breastfeeding
- Use only the amount directed, in a thin layer on the nipple, not on the rest of the breast.
- Wash hands before and after applying.
- Watch your baby for rash in the mouth, feeding changes or fussiness, and tell your prescriber.
- Tell your prescriber and pharmacist about every product you use on the area, including lanolin and creams.
- Stop and call if the area gets worse, more red or more painful.
Related Compounding Services
These pages explain related services we offer.
How It Works
Start with your prescriber
Your prescriber can fax (647) 351-2323 or send an e-prescription. You can also text a photo of your prescription to (647) 348-2323, or tap Request.
We review and prepare
A pharmacist reviews the prescription, confirms cost and coverage with you, then prepares it. Questions go to your prescriber, not to guesswork.
Free delivery or pickup
Most compounds are ready within 24–48 hours. Pick up at 2240 Lake Shore Blvd W #107 or get free delivery across the GTA.
Questions about sore nipples? Talk to a pharmacist
Our pharmacists can answer questions about sore nipples, review your current medications and coordinate with your prescriber.
Call (647) 348-2323, text a photo of your prescription, or start a request, and we will help you understand your options for sore nipples.
Sore Nipples FAQ
Is sore nipple pain normal?
Some tenderness in the first days is common. Severe or lasting pain, cracks and bleeding are not something to push through; get your latch checked.
Can I get an all-purpose nipple ointment without a prescription?
No. It is a compounded preparation and requires a prescription from an authorized prescriber.
How soon can you have it ready?
Most compounds are ready within 24–48 hours. Call us if you need it urgently so we can plan.
How do I know if I have thrush?
Burning, shiny or flaky skin and pain after feeds can be signs. A prescriber should assess it, because treatment differs from other causes.
Do I need to wipe it off before feeding?
Follow the directions on your label and your prescriber’s advice. We explain this when we dispense.
Can I use lanolin as well?
Many people do, but tell your prescriber and pharmacist so products are not layered unnecessarily.
Is it covered by insurance?
Some private plans cover some compounded prescriptions. We check first and give a cost estimate.
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2240 Lake Shore Blvd W #107, Etobicoke, ON M8V 0B1
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