Cracked nipples from breastfeeding are most often caused by a shallow latch, and they usually heal once the latch is fixed, with simple care such as expressed milk, air drying and a gentle balm helping in the meantime.
Cracked nipples can make you dread every feed. The good news is that the cause can usually be found and fixed, and many people keep feeding while they heal.
This guide covers why cracks happen, how to fix a bad latch, what the evidence says about lanolin and other remedies, how to pump without making things worse, and the signs of infection, thrush, vasospasm or tongue-tie that need a closer look.
Key Takeaways
A shallow latch is the most common cause; fix the cause first, because creams only soothe.
Expressed milk, air drying, purified lanolin or a lanolin-free balm and hydrogel pads are all options named by health sources.
A Cochrane review found most nipple pain eases to mild levels about 7 to 10 days after birth.
Blood from a cracked nipple is not harmful to your baby, per La Leche League, and pumping is an option while you heal.
Call your doctor for warmth, swelling, discharge, fever or cracks that will not heal.
Table of Contents
What Causes Cracked Nipples?
Quick Answer
Cracked nipples are usually a sign that something is putting strain on the nipple during feeds, and the most common culprit is a shallow latch. Cleveland Clinic also lists engorged breasts, a breast pump with suction set too high or the wrong flange size, frequent comfort sucking, and conditions such as tongue-tie. Fixing the cause matters more than any cream: Cleveland Clinic notes that soothing the skin only helps temporarily if the strain continues.
Cleveland Clinic calls these painful splits nipple fissures. They can affect one or both breasts, are most common in people who are breastfeeding (especially for the first time), and usually show up in the second or third week after birth. The skin may look crusty, scabbed, red or dry and feel raw or itchy.
Shallow latch: the baby sucks mainly on the nipple instead of taking in a mouthful of breast. The American Academy of Pediatrics (AAP) says this is common in the first few feedings and can cause significant pain.
Engorgement: Cleveland Clinic notes that swollen, overfull breasts (common in the first week) strain the nipple, and La Leche League adds that engorgement can flatten the nipple and make latching harder.
Pump problems: suction set too high or a flange that does not fit (Cleveland Clinic).
Your baby’s mouth: tongue-tie can stop the tongue from moving into the right position, and Mayo Clinic says the baby may chew on the nipple instead of sucking.
Nipples After a Bad Latch: How to Tell
La Leche League describes the most common cause of nipple damage as a shallow latch, where the nipple is squashed against the hard roof of your baby’s mouth. You can often see the evidence right after a feed.
The nipple looks flattened or slanted instead of round after a feed (La Leche League).
There is a pale stripe across the tip of the nipple (La Leche League).
The tip is chafed, cracked or bleeding (La Leche League).
Your baby seems hungry soon after feeding. The AAP notes that a poor latch can also cut your baby’s milk intake and lower your milk production.
Some tenderness in the first few days is common. The AAP says nipples are often tender until they adjust. Pain that gets worse, lasts all feed, or comes with visible damage is different, and it is worth getting help early instead of waiting it out. If the pain is more of a burning or stinging feeling, our guide to stinging pain in the breast while breastfeeding covers other causes.
How to Fix a Shallow Latch
These steps come from the AAP, the Office on Women’s Health, Cleveland Clinic and La Leche League:
Aim for a big mouthful: the baby’s lips and gums should cover the areola, not just the nipple (AAP). Cleveland Clinic describes the mouth covering the entire nipple and most of the areola.
Break suction before you reposition: if your baby is only on the nipple, slip a clean finger into the corner of the mouth to break suction, then try again (Office on Women’s Health).
Line your baby up: Cleveland Clinic says your baby should not need to turn their head to reach the nipple, and you should not need to shift position mid-feed.
Change positions: the AAP suggests varying the nursing position at each feeding so pressure lands on a different part of the nipple. Our breastfeeding positions guide walks through seven holds.
Start on the less sore side: La Leche League suggests offering the less sore breast first.
If you are new to feeding, our step-by-step breastfeeding guide covers latch basics. A lactation consultant (IBCLC) can watch a feed in person, which is often the fastest way to find the problem.
How to Heal Cracked Nipples at Home
There is no single agreed treatment, and La Leche League notes that experts suggest different approaches. Here is what each source we reviewed actually recommends:
Option
What the source says
Source
Expressed breast milk or colostrum
Rub a few drops on the nipple after feeds with clean hands
AAP, Office on Women’s Health, La Leche League
Air drying
Gently pat dry, then let nipples air dry or wear a soft cotton shirt
AAP, Office on Women’s Health
Purified (medical-grade) lanolin
Listed as an option after feeds; no need to wipe off before the next feed
AAP, Office on Women’s Health, La Leche League
Lanolin-free nipple balm
Recommended instead of lanolin, which can cause allergic reactions and more irritation in some people
Cleveland Clinic
Hydrogel pads or dressings
Can soothe and promote healing; check with your doctor or lactation consultant first, keep them clean and change them regularly
Cleveland Clinic, Office on Women’s Health, La Leche League
Medical-grade honey gel
A sterilized wound-care product; never use honey from a jar on nipples, because honey carries a botulism risk for babies
Cleveland Clinic
Pain relief
Ask your doctor about a non-aspirin pain reliever if pain is severe
Office on Women’s Health
Home care options for cracked nipples, by source.
A few habits help no matter which option you choose:
Wash with warm water only and skip soap on the nipples (AAP). Cleveland Clinic suggests fragrance-free soaps, shampoos and conditioners, since scented products can cause contact dermatitis.
Change nursing pads often and avoid plastic-lined pads (AAP, Office on Women’s Health). Remove plastic breast shells after 30 minutes (AAP).
Avoid general creams and lotions. The AAP says they generally do not help and may make things worse.
Do not put off feeds because of pain. The Office on Women’s Health says delaying feeds can worsen pain and harm milk supply.
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Lanolin, Breast Milk or Nothing? What the Research Says
Most guides list lanolin as the go-to fix, but the evidence is thin. A 2014 Cochrane systematic review by Dennis, Jackson and Watson looked at treatments for painful nipples in breastfeeding women and found only four small trials of low quality, so it could not firmly recommend any treatment.
Lanolin alone was not clearly better than applying nothing.
Expressed breast milk lowered pain compared with lanolin after four to five days, but the difference was gone by six to seven days, and it was no different from applying nothing.
Glycerine gel pads did not significantly improve nipple pain.
The authors concluded that applying nothing or expressed breast milk may be as good as or better than an ointment like lanolin for short-term pain.
The same review found something reassuring: regardless of which treatment women used, most women’s nipple pain dropped to mild levels about 7 to 10 days after giving birth.
The practical takeaway: a balm can add comfort, but the latch and the cause are where healing happens.
Can You Keep Breastfeeding While You Heal?
In most cases, yes. La Leche League says blood from cracked nipples is not harmful to your baby. If you are not sure where blood in spit-up is coming from, ask your pediatrician.
You also do not have to grit your teeth through every feed. If nursing is too painful, Cleveland Clinic says pumping and bottle feeding while you heal is an option, and La Leche League says you can express milk and feed it another way for one feed or a longer break without your baby forgetting how to breastfeed. If you bottle feed for a while, paced bottle feeding keeps the flow closer to the breast.
Cleveland Clinic also suggests alternating breasts so neither nipple is overworked. Keep an eye on your baby’s diapers and weight during any change in routine; our guide to signs your milk supply is decreasing explains what to watch.
Pumping While You Heal: Flange Fit and Suction
Pumps cause cracks too. Cleveland Clinic lists suction set too high and the wrong flange size as causes of nipple fissures, and recommends a comfortable yet effective suction level with a correctly sized flange.
Flange too big: La Leche League says it pulls too much areola into the tunnel, causing rubbing and soreness.
Flange too small: it rubs the nipple itself (La Leche League).
Measure: La Leche League suggests measuring the width of your nipple tip in millimeters. The most comfortable flange often matches nipple size, and each breast may need a different size.
Turn suction down: La Leche League says pumping should be comfortable, with milk released by your let-down rather than forced out by high suction.
Cleveland Clinic says healing takes from a few days to a few weeks, and soreness may improve sooner than the skin does. The Cochrane review above found most women’s nipple pain eased to mild levels about 7 to 10 days after birth, whatever treatment they used.
If cracks are still open after a week or two, or pain is getting worse, have the latch, your baby’s mouth and the skin checked rather than trying another cream.
Signs of Infection: Mastitis, Bacterial Infection or Thrush
An open crack is a break in the skin, and Cleveland Clinic says germs can get in and lead to bacterial mastitis or an abscess. Watch for these signs:
Bacterial infection of the nipple: La Leche League lists burning pain, yellow discharge, crusting, swelling, color change or wounds that do not heal. Contact your doctor, since antibiotics may be needed.
Mastitis: a warm, swollen, painful area of the breast, often with fever, chills or flu-like aches. See our mastitis guide.
Thrush (yeast): the Office on Women’s Health lists sore nipples that last more than a few days despite a good latch, sudden soreness after weeks of comfortable feeding, pink, flaky, shiny, itchy or cracked nipples, and shooting pains deep in the breast during or after feeds.
Sources disagree on thrush. The Office on Women’s Health describes nipple thrush and treatment with a medicine rubbed on for about a week. Cleveland Clinic says research finds little to no evidence that yeast infects the nipple, and that dermatitis, milk blebs, subacute mastitis or vasospasm are more likely causes. Get a diagnosis instead of self-treating. Your baby’s mouth is a separate question: Cleveland Clinic describes oral thrush as white patches on the gums, tongue or lips that do not rub off, sometimes with fussiness at feeds or a diaper rash.
Nipple Vasospasm and Tongue-Tie: When Pain Has Another Cause
Nipple vasospasm. Cleveland Clinic describes a nipple that turns paler, with pain that radiates deep into the breast. It can be linked to Raynaud’s syndrome and is made worse by cold, a poor latch, ill-fitting pump flanges or oversupply. Symptoms often show up right after feeding or pumping. Cleveland Clinic lists heat, such as breast warmers, as the treatment, so air drying is not the answer for this one.
Tongue-tie. Mayo Clinic explains that a baby needs to keep the tongue over the lower gum while sucking. If a tight band of tissue stops that, the baby may chew on the nipple instead, which can cause significant nipple pain and make it harder for the baby to get enough milk. Cleveland Clinic says providers may check your baby’s mouth for tongue-tie when cracks keep coming back. Ask your pediatrician or an IBCLC to assess it; Mayo Clinic advises seeing a doctor if signs of tongue-tie cause problems such as difficulty breastfeeding.
When to Talk to Your Doctor or a Lactation Consultant
Contact your doctor, midwife or a lactation consultant (IBCLC) if:
Cracks are not healing, or the pain is getting worse instead of better (Cleveland Clinic).
The nipple or breast feels swollen or warm to the touch (Cleveland Clinic).
You see yellow discharge, crusting or a wound that will not heal (La Leche League).
Pain makes it hard to nurse or pump (Cleveland Clinic), or the AAP’s warning sign applies: severe nipple pain or significant cracking that makes nursing too painful.
Your baby has white patches in the mouth, seems to chew at the breast, or is not gaining weight well.
Call your doctor the same day if you develop fever, chills or flu-like symptoms (Cleveland Clinic), especially with a red, painful area of the breast, because this can be mastitis.
Call 911 or go to the nearest emergency room if you feel severely ill, confused or short of breath, or cannot keep fluids down. This article is general education, not medical advice.
Frequently Asked Questions
How long do cracked nipples take to heal?
Cleveland Clinic says cracked nipples take from a few days to a few weeks to heal, and soreness often improves sooner. A Cochrane review found most women’s nipple pain fell to mild levels about 7 to 10 days after birth. Healing is usually faster once the latch or pump fit is corrected.
Should I keep breastfeeding with cracked nipples?
Usually yes. La Leche League says blood from cracked nipples is not harmful to your baby. If feeding is too painful, Cleveland Clinic says pumping and bottle feeding while you heal is an option. Keep removing milk regularly so your supply and comfort are protected, and get the latch checked.
What is the fastest way to heal a cracked nipple?
Fix the cause first, usually the latch or pump fit. Then keep the area clean with warm water, apply expressed milk or a balm you tolerate, and change nursing pads often. Hydrogel pads may help, but the Office on Women’s Health suggests checking with a doctor or lactation consultant before using them.
Does lanolin help cracked nipples?
The AAP and the Office on Women’s Health list purified lanolin as an option. A 2014 Cochrane review found lanolin was not clearly better than applying nothing, and Cleveland Clinic notes lanolin can cause allergic reactions in some people. It may add comfort, but it does not fix the underlying cause.
Is it OK if my baby swallows blood from my nipple?
La Leche League says blood from cracked nipples is not harmful to your baby. You might see small streaks in spit-up or pumped milk. If your baby vomits blood, seems unwell, or you cannot tell where the blood came from, call your pediatrician to check.
Why do my nipples keep cracking even with a good latch?
Other causes include pump suction set too high, a poorly fitted flange, engorgement, tongue-tie, skin irritation or infection. Cleveland Clinic also describes vasospasm, where the nipple turns pale and pain radiates deep into the breast. A lactation consultant or doctor can help find the cause.
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