Painful Breastfeeding (Sore Nipples)
Medically reviewed by Dr. Rachel Kim, MD, RDN · Pediatric Nutrition Specialist
Content reviewed against published AAP, AAP, WHO guidelines
Last reviewed:
Feeding challenges are one of the most common concerns new parents face. When it comes to painful breastfeeding (sore nipples), here is what the guidelines recommend.
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.
Key takeaways
- 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.
- Usually normal when: You feel brief tenderness for the first 10 to 15 seconds of latching during the first week that resolves once milk begins flowing
- Call your doctor if: You have a painful, red, warm area on your breast with fever over 100.4F, which may indicate mastitis requiring antibiotics
- Varies by age — see the age-by-age breakdown below
“The AAP recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, for 2 years or beyond.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, WHO guidelines, 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. At 0-2 weeks, 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. It is generally considered normal when you feel brief tenderness for the first 10 to 15 seconds of latching during the first week that resolves once milk begins flowing. However, you should contact your pediatrician promptly if you have a painful, red, warm area on your breast with fever over 100.4F, which may indicate mastitis requiring antibiotics.
Normal vs. Concerning
By Age
What to expect by age
0-2 weeks
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.
2-6 weeks
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.
6-12 weeks
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.
3-6 months
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.
6-12 months
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 to Tell Your Pediatrician
- Describe when you first noticed painful breastfeeding (sore nipples) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if pain lasts throughout the entire feeding session and does not improve after the first two weeks.
- Mention if you see cracks, blisters, or bleeding on your nipples that are not healing.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice painful breastfeeding (sore nipples) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that you feel brief tenderness for the first 10 to 15 seconds of latching during the first week that resolves once milk begins flowing — this is generally within the range of normal.
- At 0-2 weeks, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Offer feeding in a calm, distraction-free environment. Avoid forcing or pressuring your baby to eat.
- While monitoring at home, seek immediate care if you have a painful, red, warm area on your breast with fever over 100.4F, which may indicate mastitis requiring antibiotics.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Feeding & Nutrition Guide
Complete guide to breastfeeding, formula feeding, and solid food introduction.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is painful breastfeeding (sore nipples) normal?
When should I call the doctor about painful breastfeeding (sore nipples)?
When is painful breastfeeding (sore nipples) normal?
What causes painful breastfeeding (sore nipples)?
What should I mention to my pediatrician about painful breastfeeding (sore nipples)?
Is painful breastfeeding (sore nipples) normal at 0-2 weeks?
Is painful breastfeeding (sore nipples) normal at 2-6 weeks?
Should I go to the ER for painful breastfeeding (sore nipples)?
Does painful breastfeeding (sore nipples) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Painful Breastfeeding (Sore Nipples).
Things to mention
- Describe when you first noticed painful breastfeeding (sore nipples) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if pain lasts throughout the entire feeding session and does not improve after the first two weeks.
- Mention if you see cracks, blisters, or bleeding on your nipples that are not healing.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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
Urgent signs to report immediately
- 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
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of painful breastfeeding (sore nipples) are normal. Talk to your pediatrician if you have a painful, red, warm area on your breast with fever over 100.4f, which may indicate mastitis requiring antibiotics.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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