Sore nipples are probably the most common difficulty mothers have when breastfeeding. Sore nipples may be caused by different factors. Determining the cause of sore nipples dictates the appropriate treatment. A certified lactation consultant (IBCLC) will be able to help and suggest intervention.
Breastfeeding should not hurt, and the skin on your nipple should not break down any more than the skin anywhere on your body should break down. However, mild tenderness, similar to the kind of tenderness some women experience with their menstrual cycles, is fairly common for the first week or two of breastfeeding. Then it should go away.
If your nipples feel painfully sore or the nipples or areola feel bruised, it is more likely that it is related to an improper latch-on process or ineffective sucking. Suspect a difficulty with baby's latch or sucking if your nipples become very red, raw, blistered, or cracked. A latch or sucking difficulty or a structural variation in the baby's mouth might result in nipples that look creased or blanched (turn white) at the end of feedings. Certain creams or dressings may promote healing, but others can actually cause more damage. Also, avoid any treatment that might result in drying the nipple tissue, which may lead to cracking of the skin.
When nipples become red and burn, or feel extremely sore after weeks or months of pain-free breastfeeding, it may be due to a yeast infection such as thrush. Yeast may appear as white patches in the baby's mouth or it may show up as a bright red diaper rash. Specific medications are needed to treat yeast infections. Contact your baby's physician for more information and treatment.