My nipple fissures weren’t showing any signs of improving, so after a day of deliberation, I phoned the National Childbirth Trust. I was starting to realise that the fact that there were helplines (and whole charities, in the case of La Leche League) dedicated to solving breastfeeding problems should probably have served as a warning that it might not be that easy. The counsellor who answered the phone was helpful, if a little abrupt. She asked me which direction my nipples pointed (!) and when I said it was slightly outwards, rather than directly forwards, she said that they were probably getting bent backwards in C’s mouth when I was holding her in the cradle feeding position. She suggested using a different position to feed her (such as the rugby/football hold, where C’s mouth would approach the nipple from the opposite direction) while I waited for them to heal. This seemed sensible advice, and after a few goes, C and I managed to perfect some new feeding positions. Although I can’t say it was definitely less painful, the knowledge that C’s mouth probably wasn’t putting pressure on my nipples in the same way seemed to help at least psychologically.
The NCT counsellor, like every midwife I spoke to, also recommended I use Lansinoh cream – ‘absolutely loads of it, as a barrier’ – to protect my nipples. I had been religiously applying it since the bleeding had started, and following advice, continued to do so as the state of my nipples got worse. After a few more days, I stopped to think about this: the state of my nipples was getting worse…
Up to now, still in a post-birth haze, I’d been relying on the NHS resources, reading the leaflets and speaking to midwives and health visitors. They’d been very understanding and sympathetic, but things weren’t really improving, and I was getting desperate. I decided to start Googling in earnest, searching for things like ‘nipple fissures’, and going beyond the first page – sometimes even as far as the fifth! What I ended up with was quite a lot of hits for ‘anal fissures’ (not terribly useful), but in amongst these and the general parenting advice sites, was a scientific paper looking at treatments for cracked nipples1.
The study compared using lanolin cream (like Lansinoh) with using breast milk, and leaving nipples untreated. A short summary of the results goes as follows: the women who used breast milk on their nipples, or who did nothing at all, recovered significantly faster than the ones using lanolin (for a longer discussion see the is lanolin cream a waste of money? post).
Armed with this knowledge, I dumped the Lansinoh, and within only a few hours, things seemed to improve. I can’t be sure whether this was as a direct consequence of not applying the cream, but it seemed to be working, and I decided to stick with it.
Given the high incidence of nipple pain (it seems most women experience it when they start breastfeeding
Having been told that my initial breastfeeding difficulties – cracked, bleeding, excruciatingly painful nipples – were quite normal (despite what the official literature said), I was looking forward to the three week deadline after which everything would be functioning as it should. I was, however, slightly perturbed by the fact that as he deadline approached, no improvement was evident. In fact, my nipples were getting much, much worse. My husband expressed genuine concern that C was going to chew one of them off! By this stage, the bleeding had stopped, but it had been replaced by deep, ulcerated gashes on the outside edge of each nipple. I dreaded feeding, and as C wanted to do so 10-12 times a day, I spent all 24 hours either in pain, or anticipating its imminent start.
The first couple of days at home were pretty breezy. Before I left hospital I was assured by two midwives that C was latching on properly – cheeks puffed out, chin pumping, ears wiggling – so I was confident we had the technique sorted. Family visited and I assured them everything was going well, demonstrating our successful feeding on several occasions. By the time I got to day four, however, things weren’t quite so easy. Accompanying the hormone-induced plunge into despair inadequately named ‘the baby blues’ (that coincides with the start of proper milk production) was a serious deterioration of my nipples.
One 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.
The Truth About Breastfeeding 