Does pale skin mean problem nipples?

test tubes and tape measureOne of the anecdotes you may have heard (particularly if you are pale) is that women with fair skin are more likely to experience sore or damaged nipples. If you have very light skin and painful nipples (as I did), it may be strangely reassuring to be able to attribute at least some of the difficulties you’re experiencing to your colouring. On the other hand, if you have dark skin and sore nipples, you may simply view this kind of statement as irritating nonsense.

Is there any evidence that skin colour is associated with nipple problems when breastfeeding? There don’t seem to be any studies looking solely at the relationship between the two, but there are some studies that have included it as a factor, and the results they report are mixed. Whilst one study looking at breastfeeding in the first few days after birth found an association between nipple damage and skin colour1, another found that there was no link between the two2.

To confuse matters further, some research looking at the effect of ‘conditioning’ nipples prior to breastfeeding (by rubbing them with a rough towel – ouch!) found that women with fair skin reported significantly more pain when feeding on the unconditioned nipple, and olive skinned women reported significantly more pain when feeding on the conditioned nipple3. (I should mention that this research was carried out in 1979 – actively damaging you nipples whilst pregnant to ‘toughen them up’ for breastfeeding is no longer recommended.)

So, it seems the jury’s still out on this one. I suppose the most important thing to remember is that whilst there may be some link between fair skin and nipple pain or damage when breastfeeding, there certainly isn’t conclusive evidence for this, and there definitely are reports from women of all skin types that breastfeeding can be very painful!

  1. Rev Bras Enferm. 2005 Sep-Oct;58(5):529-34
  2. Birth. 1987 Mar;14(1):41-5.
  3. Nurs Res. 1979 Sep-Oct;28(5):267-71
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