Painful Breastfeeding (Sore Nipples)
The short answer
Some nipple tenderness in the first few days of breastfeeding is common as your body adjusts, but persistent or severe pain is not something you should push through. In most cases, breastfeeding pain is caused by a latch issue that can be corrected with proper positioning. Getting help early from a lactation consultant can make a world of difference.
By Age
What to expect by age
Mild nipple soreness during the first one to two weeks is very common as nipples adjust to frequent nursing. However, pain that makes you dread feeding, causes visible cracks or bleeding, or lasts throughout the entire feed (not just the first few seconds) usually signals a latch problem. Focus on getting a deep, asymmetric latch where your baby takes a large mouthful of breast, not just the nipple. Their lips should be flanged outward, and you should hear rhythmic swallowing. Lanolin cream, expressed breast milk on the nipples, and gel pads can help heal soreness between feeds.
If pain continues past the first two weeks, it is not normal and deserves attention. Common causes include a shallow latch, tongue tie or lip tie, or a positioning issue. Thrush (a yeast infection) can also develop during this period, causing burning, shooting pains that continue between feeds and sometimes a white coating in your baby's mouth. Have your baby evaluated for tongue tie if you have not already, and see a lactation consultant for a latch assessment.
By this point, breastfeeding should be comfortable. If you are still experiencing pain, there may be an underlying issue such as an undiagnosed tongue tie, vasospasm (blanching of the nipple after feeds, often worse in cold weather), or a bacterial infection. Do not give up without seeking help, as these conditions are treatable. A board-certified lactation consultant (IBCLC) can do a thorough assessment.
New-onset pain at this stage often relates to teething or biting. Babies may clamp down when teething or at the end of a feed when milk flow slows. You can try briefly unlatching your baby when they bite, offering a teething toy before nursing, and watching for signs they are finished eating. Recurring plugged ducts or mastitis can also cause breast and nipple pain.
Older babies with teeth can cause nipple trauma if they bite or if the latch becomes lazy. Breastfeeding should still be comfortable at this age. If pain develops suddenly, check for a new tooth, changes in latch due to distractibility, or a breast infection. You can gently say "no biting" and unlatch your baby briefly to teach them that biting ends the feeding session.
What Should You Do?
When to take action
- You feel brief tenderness for the first 10 to 15 seconds of latching during the first week that resolves once milk begins flowing
- Your nipples feel slightly sensitive between feeds in the first few days but are not cracked or bleeding
- Mild soreness improves day by day during the first two weeks
- Occasional discomfort when your baby first latches in a new position but the rest of the feed is painless
- Pain lasts throughout the entire feeding session and does not improve after the first two weeks
- You see cracks, blisters, or bleeding on your nipples that are not healing
- You notice burning or shooting pain in your breasts between feedings, which may suggest thrush or vasospasm
- You have a painful, red, warm area on your breast with fever over 100.4F, which may indicate mastitis requiring antibiotics
- Pain is so severe that you are unable to feed your baby at all and they are not getting enough to eat
Sources
Related Resources
Related Feeding Concerns
I'm Worried My Baby Is Aspirating During Feeds
Aspiration means liquid or food enters the airway instead of the stomach. Occasional coughing during feeds is common and does not usually indicate aspiration. True aspiration is less common and may present as recurrent respiratory infections, a wet or gurgly voice after feeds, or chronic cough. If you are concerned, a swallow study can provide a definitive answer.
Baby Biting Nipple While Nursing
Biting during breastfeeding is a common challenge, especially when babies start teething. It can be startling and painful, but it is almost always a phase that can be managed. Babies cannot actively nurse and bite at the same time because their tongue covers the lower teeth during proper sucking. Biting typically happens at the beginning or end of a feed when the latch is not active. With some gentle strategies, most babies learn quickly that biting ends the feeding session.
My Baby Keeps Choking on Food
First, it's important to distinguish between gagging and choking. Gagging is a normal protective reflex that helps babies learn to eat, while true choking is silent and requires immediate intervention. Most "choking" episodes parents describe are actually gagging, which is common and expected as babies explore new textures. However, if your baby frequently struggles with swallowing or shows signs of true choking, it's worth discussing with your pediatrician.
My Baby Coughs While Feeding
Occasional coughing during feeding is very common, especially in newborns who are still learning to coordinate sucking, swallowing, and breathing. It often happens with a fast milk flow or letdown. However, if your baby coughs with every feed or turns blue or has difficulty breathing, this needs medical evaluation to rule out swallowing difficulties.
Baby Falling Asleep While Nursing
It is very common for babies to fall asleep while nursing, especially in the newborn period. Breastfeeding releases hormones that make both you and your baby feel relaxed and sleepy. In most cases this is completely normal, but if your baby is not gaining weight well or consistently falls asleep within a minute or two of latching, it may be worth trying some gentle techniques to keep them feeding longer.
Baby Gagging on New Textures
Gagging on new textures is one of the most common parts of learning to eat and is a normal, protective reflex. It does not mean your baby is choking or that they cannot handle the texture. The gag reflex is positioned far forward on the tongue in young babies, which means they gag more easily. With consistent, gentle exposure, most babies gradually learn to manage new textures. Going at your baby's pace while continuing to offer varied textures is the best approach.