Nipple Wound Healing: How to help your nipples heal

Nipple pain is not something you simply have to put up with when breastfeeding. While some tenderness can occur during the early days, breastfeeding should not remain painful, and persistent or worsening pain is a sign that something needs looking at. If your nipples hurt at every feed, or they are cracking or bleeding, it is important to seek help early rather than waiting for the problem to become more severe (NHS, 2026).

Nipple trauma can range from soreness and irritation through to cracks, bleeding, blisters and open wounds. One of the most common causes is ineffective positioning or attachment, which can result in the nipple being compressed during feeding (NHS, 2026). Sometimes the cause is relatively simple and a small adjustment can make a significant difference. At other times, there may be several factors contributing to the problem, including infant oral function, pumping, skin conditions, vasospasm or infection (Berens et al., 2016).

The important thing is to identify what is causing the trauma rather than simply trying to manage the pain.

Why an IBCLC can be helpful

An International Board Certified Lactation Consultant (IBCLC) is a specialist in breastfeeding, lactation and infant feeding. Their role involves assessing the feeding process as a whole, rather than simply looking at the nipple in isolation.

An IBCLC can assess how your baby is attaching and feeding, how milk is being transferred, your baby's oral function, your pumping technique and flange fit where relevant, as well as factors affecting your breasts, nipples and milk supply. Persistent nipple pain is recognised as something that requires assessment of both maternal and infant factors, including feeding dynamics and possible causes of nipple trauma (Berens et al., 2016).

An IBCLC can also consider the wound itself and suggest supportive measures that may help create the right environment for healing. There are a range of non-prescription wound-care options available, and a lactation specialist may be aware of approaches that a parent, or a healthcare professional who does not routinely work in lactation and nipple trauma, may not have considered.

The choice of approach should be based on the condition of the nipple, the nature of the wound, the suspected cause and the individual feeding circumstances. The aim is not simply to find something to put on the nipple, but to support healing while also addressing whatever is causing the trauma.

Treat the wound, but don't forget to treat the reason the wound happened.

Creating the right environment for healing

Nipple wounds, like other wounds, need the right environment to heal. Wound-healing principles support maintaining an appropriately moist environment for epithelialisation, but appropriately moist does not mean constantly wet.

There is an important difference between supporting a wound with enough moisture to prevent it from drying out and allowing the skin to remain saturated. Excessive moisture can soften the skin and contribute to maceration, leaving damaged tissue more vulnerable to further irritation.

This is particularly relevant when nipples are already cracked or injured. Anything that creates prolonged friction, pressure or excessive moisture needs to be considered as part of the overall picture.

Gentle nipple care is therefore important. Avoid unnecessary washing of the nipples, particularly with harsh soaps or products that can strip the natural protective barrier of the skin. If breast pads become damp, changing them regularly can help prevent prolonged exposure to moisture. Reducing friction against clothing and allowing the nipple to remain comfortable between feeds can also help.

The goal is not to keep the nipple completely dry at all costs, but to create an environment in which damaged tissue can heal without being repeatedly irritated or traumatised.

Silver Nipple Cups and Shells

Silver nipple cups have become increasingly popular as a way of protecting sore or damaged nipples between feeds. The use of silver in wound care has generated interest, and some research has reported improvements in nipple trauma with silver nipple protectors. However, the evidence remains limited and does not establish silver nipple cups as a superior or guaranteed treatment for nipple wounds.

The evidence base for silver products is still developing, and stronger comparative research is needed before firm conclusions can be drawn about their effectiveness.

There is also an important practical consideration: the environment created underneath a silver cup matters.

Because a cup sits over the nipple, moisture can become trapped. If the nipple remains wet for prolonged periods, the skin can become macerated rather than supported in healing. This does not mean that silver cups are inappropriate for everyone, but prolonged moisture needs to be considered when a nipple wound is failing to heal.

Silver cups and shells may also collect milk. For someone who is already producing more milk than their baby needs, repeatedly collecting milk or providing additional breast stimulation may be relevant when considering the wider feeding picture. This does not mean that silver cups cause oversupply, but it is something worth considering if oversupply is already an issue.

The quality and composition of silver products can also vary. The fact that a product contains silver does not, by itself, guarantee that it will provide a particular clinical benefit.

If you are using silver cups and they are comfortable and your nipples are healing, there is no reason to assume that you are doing something wrong. However, if healing is not progressing, it is worth looking at the whole situation rather than simply adding another product. The NHS currently advises that silver nipple cups can be used between feeds when nipples are cracked, while also noting that breast shells can affect attachment (NHS, 2026).

What about lanolin?

Lanolin is one of the products parents are most commonly asked about when they have sore or damaged nipples. It is derived from sheep's wool and is widely used as an emollient in moisturising and skin-care products.

Highly purified lanolin is generally well tolerated by people who are not allergic or sensitive to it. It has been used extensively in breastfeeding care, and many breastfeeding parents use it without problems.

However, lanolin can cause irritant or allergic contact dermatitis in some people. Wool alcohols are recognised sensitising substances, and reactions can cause symptoms such as itching, burning, redness, swelling, scaling or increasing soreness. A reaction can therefore make an already damaged nipple feel worse or appear not to be healing.

This does not mean that everyone using lanolin will develop a reaction. If you are already using lanolin, it feels comfortable, and your nipples are healing, there is no need to panic or assume that the product is harming you.

There is also limited evidence that lanolin is particularly effective at reducing nipple pain compared with other approaches. In a randomised controlled trial involving 186 breastfeeding women with nipple pain or damage, lanolin did not significantly reduce pain compared with usual postpartum care, although both groups experienced clinically relevant improvement over time (Jackson & Dennis, 2017). A 2026 systematic review and meta-analysis of randomised trials also found no clear advantage of lanolin over expressed breast milk for reducing nipple cracks or pain, with the certainty of the evidence remaining low (Barja-Ore et al., 2026).

The important question is therefore not whether lanolin is universally "good" or "bad", but whether it is appropriate for your individual skin and circumstances.

If your nipples become increasingly itchy, burning, red, swollen, flaky or sore after using a product, stop and seek professional advice rather than assuming that you simply need to apply more.

When the nipple changes shape after a feed

The appearance of your nipple immediately after a feed can provide useful information about what is happening during feeding.

A nipple that comes out of your baby's mouth flattened, wedged, compressed or unusually pale or white may indicate that it has been compressed during the feed. When attachment is ineffective, the nipple can be held towards the front of the baby's mouth and compressed against the hard palate, causing pain and potentially contributing to nipple damage (NHS, 2026).

A small adjustment to positioning or attachment can sometimes make a significant difference. This is one reason why having a feeding assessment can be much more useful than simply being told to apply a cream.

The shape of the nipple is not, however, a diagnosis by itself. It needs to be considered alongside the baby's oral movements, attachment, sucking pattern, milk transfer and the parent's symptoms.

Nipple blanching, vasospasm and colour changes

Not all nipple pain is caused by a wound.

Some breastfeeding parents experience vasospasm, where the blood vessels in the nipple constrict. This can cause the nipple to become white or blanched, sometimes followed by a change to purple or red as blood flow returns. The pain may be sharp, burning or shooting and can occur during or after a feed. Cold temperatures can also trigger or worsen symptoms (Berens et al., 2016).

Vasospasm can occur alongside nipple trauma, particularly when the nipple has already been subjected to compression. This means that simply treating the visible crack or wound may not resolve the underlying pain if there is another contributing factor.

Persistent nipple pain therefore deserves proper assessment rather than automatically being attributed to "just breastfeeding".

Could tongue-tie be contributing?

Tongue-tie is often discussed when a breastfeeding parent is experiencing nipple pain, but the presence of a frenulum does not, by itself, mean that tongue-tie is causing a feeding problem.

A frenulum is normal anatomy. The important question is what effect, if any, it is having on tongue function and feeding.

Some infants with restricted tongue function may have difficulty achieving or maintaining an effective attachment, which can contribute to nipple compression and pain. The NHS recognises tongue-tie as one possible factor contributing to difficulty attaching and sore or cracked nipples (NHS, 2026).

This is why assessment should consider function rather than simply the appearance of the frenulum.

Anatomy provides information. Function provides context.

If a frenulotomy is undertaken, the procedure itself is not necessarily the end of the feeding assessment.

The tongue is a muscular hydrostat made up of eight paired muscles: four intrinsic and four extrinsic muscles. These muscles work together to create the complex movements required for tongue function. Following release, there may still be issues relating to movement, strength, tone, coordination or compensatory patterns that need to be considered.

Addressing residual tensions and helping the tongue develop appropriate strength, tone and coordinated movement can therefore be an important part of supporting functional feeding.

If an underlying mechanical or functional factor continues to contribute to nipple compression or poor attachment, simply waiting for the wound to heal may not solve the problem. The nipple can continue to be traumatised with every feed, making healing slower and potentially prolonging pain.

This is why treating the wound and treating the reason for the wound need to happen together.

Pain after the cause has been corrected

Even when the underlying cause of nipple trauma has been identified and corrected, pain may not disappear immediately.

Damaged tissue needs time to repair. A nipple that has been cracked, grazed or bleeding may remain tender while the wound heals, even if feeding mechanics have already improved.

The important distinction is between pain from healing tissue and ongoing trauma.

If each feed continues to cause fresh damage, the nipple repeatedly cracks or bleeds, the wound is getting larger, or pain is becoming progressively worse, the original cause may not have been fully addressed.

You should not feel that you simply have to endure severe pain while waiting for your nipples to heal. Persistent nipple pain is recognised as a clinical problem requiring assessment of potential underlying causes rather than simply continued tolerance of the symptoms (Berens et al., 2016).

Keeping your milk supply going while your nipples heal

When nipples are extremely painful, it can be tempting to stop breastfeeding completely.

Sometimes a temporary change in how milk is removed can be helpful while the nipple begins to heal, particularly if direct feeding is causing significant trauma. Hand expression can provide a gentle alternative for some people and may be easier on a damaged nipple than repeated feeding or pumping.

However, completely stopping milk removal without a plan can reduce milk production because milk supply is closely linked to milk removal. The NHS therefore recommends continuing to breastfeed where possible or expressing milk by hand if feeding is too painful, while seeking help to address the underlying cause (NHS, 2026).

The aim is to find a way of maintaining milk removal while reducing further trauma. The best approach will depend on your circumstances, your baby's age and feeding needs, your milk supply and the severity of the nipple injury.

A temporary adjustment does not mean that you have failed at breastfeeding, nor does it mean that you have to stop breastfeeding permanently.

When a wound may need medical assessment

Not every cracked nipple is infected, and not every persistent nipple problem is caused by infection. However, damaged skin can provide an opportunity for infection to develop, and infection is one of the possible causes of persistent nipple and breast pain (Berens et al., 2016).

Seek medical assessment if you develop increasing redness, warmth or swelling, discharge or pus, significant deterioration in the wound, or systemic symptoms such as fever or feeling generally unwell.

Persistent pain that is not improving also deserves assessment, particularly if the cause is unclear or the wound is failing to heal.

Sometimes the answer is not another product. Sometimes the important step is identifying something that has been missed.

The most important step is finding the cause

There are many products, techniques and pieces of advice available for sore nipples. It can be tempting to keep trying different creams, cups, shells or other approaches in the hope that one of them will finally solve the problem.

But nipple trauma is a wound, and a wound that is repeatedly being injured will struggle to heal.

If attachment is causing compression, attachment needs to be addressed. If infant oral function is contributing, that needs to be assessed. If pumping or flange fit is causing trauma, that needs attention. If there is a skin condition, vasospasm, infection or another contributing factor, that needs to be considered too (Berens et al., 2016).

Healing is not simply about what you put on the nipple. It is about creating the right conditions for healing while removing the reason the injury keeps happening.

Treat the wound, but don't forget to treat the reason the wound happened.

If you are experiencing nipple pain, cracking or bleeding, you do not have to wait until the problem becomes severe before seeking help. Early assessment can sometimes identify a relatively simple change that prevents a small injury from becoming a persistent problem (NHS, 2026).

References

Barja-Ore, J., Vargas-Fernández, R., Comandé, D., Santero, M. & Hernández-Vásquez, A. (2026). Efficacy and safety of topical application of breast milk compared with lanolin for reducing nipple cracks and pain in breastfeeding mothers: systematic review and meta-analysis. Breastfeeding Medicine. doi:10.1177/15568253261470292.

Berens, P., Eglash, A., Malloy, M. & Steube, A.M. (2016). ABM Clinical Protocol #26: Persistent Pain with Breastfeeding. Breastfeeding Medicine, 11(2), pp.46–53. doi:10.1089/bfm.2016.29002.pjb.

Jackson, K.T. & Dennis, C.-L. (2017). Lanolin for the treatment of nipple pain in breastfeeding women: a randomized controlled trial. Maternal & Child Nutrition, 13(3), e12357. doi:10.1111/mcn.12357.

National Health Service (NHS). (2026). Sore or cracked nipples when breastfeeding. Reviewed 16 June 2026.

National Health Service (NHS). (2026). Breast pain and breastfeeding. Reviewed March 2026.