Breastfeeding was a troublesome business for Helen Wong. "It was excruciating," she remembers. "I had a huge tear on the nipple, which was aggravated each time I tried to latch my baby on. I felt like I was going mad from the pain."

 

Wong is not alone. Sore nipples are not uncommon among nursing mothers, especially in the first few weeks after a baby's birth. Worst of all, many women think the pain is normal. Many put up with the discomfort in the hope it will somehow get better, or that they can tough it out. Unfortunately, this only makes things worse.

 

"It's normal to feel some discomfort when you nurse your baby during the first few days," says Sarah Hung, leader of La Leche League, the international breastfeeding support group. "However, if you are experiencing pain then something is wrong and you need to seek help immediately."

 

Fortunately, in most cases the pain can be relieved – with correct information and a good dose of encouragement. Sore nipples are often caused by incorrect positioning of the baby at the breast. A poor sucking motion from the baby or sometimes a yeast infection may also make breastfeeding painful. Lactation consultants or La Leche League leaders can work with the mother to help her adjust the position of the baby as it nurses.

 

"It's important that when the baby latches on, his mouth covers a large portion of the areola, not just the tip of the nipple," says Hung. "The baby's mouth needs to be wide open before he latches on – as if he's yawning."

 

Engorgement of the breast when the milk first "comes in" can also cause difficulties for a new baby who is learning how to nurse. "Try expressing a small amount of milk by hand before you feed the baby," suggests Hung. "This relieves some of the fullness and makes it easier for the baby to latch on."

 

Bottle-feeding during the early days and weeks of the baby's life may also cause problems. A baby uses different jaw, tongue and mouth motions to suck from a bottle.

 

When mothers revert to breastfeeding, the change in sucking motion may cause nipple soreness, or the baby may refuse the breast entirely, leading to breast engorgement.

 

Hospital guidelines drawn up by UNICEF (United Nations Children's Fund) state that no artificial teats or pacifiers should be given to breastfeeding infants. If mothers need to give their babies expressed milk, they are advised to use a spoon, syringe or feeding cup.

 

When mothers have cracked, sore or even bleeding nipples, they may – understandably – decide to call it quits and reach for a bottle of formula milk. Lactation experts, however, encourage mothers to persevere. "Sudden weaning can lead to engorgement, plugged ducts and breast infections," warns Hulda Thorey, director of Annerley Midwives.

 

Thorey warns mothers to be wary of applying ointments to the nipple area, with the exception of Lansinoh cream, which is a pure form of lanolin. "Lansinoh promotes more rapid healing and offers soothing relief to sore skin," she says.

 

The cream has the added advantage of being pesticide-free and does not need to be removed before feeds.

 

The good news is that once the cause of the soreness has been established and corrected, the pain usually fades within a couple of days. Many mothers are surprised how quickly breastfeeding then becomes an enjoyable experience.

 

"Breastfeeding is a learned art," says Hung, "We say to mothers, "Please don't suffer in silence – seek help."