Breast pain can be caused by lack of frequent or effective milk removal, vasospasm, referred pain from an injury, or infection.  It can be difficult to tell the difference between these causes of pain.

If your breast has a painful lump or if you have a fever and body aches you may have plugged ducts or mastitis.  If you nipples and breasts are sore but there are no lumps or fever, you may still have a bacterial infection.  If nipples are red, damaged or cracked, consider these suggestions.

Many parents are diagnosed with a breast yeast infection if they have pain in their breasts and nipples but it is more commonly a bacterial infection or vasospasm. One promising treatment for bacterial infection of the breast is probiotics.

If you have shooting or burning pains during and between feeds, you may have vasospasm.  Vasospasm occurs when the nipples are compressed, causing a lack of blood flow.  If your nipples look pinched after breastfeeding, vasospasm is the likely cause of pain.  Vasospasm can also be associated with Raynaud’s syndrome in which pain occurs when nipples become chilled.  Raynaud’s affected nipples often have a color change from white to blue to red.  Vasospasm or Raynaud’s can be relieved by quickly covering nipples after baby unlatches, in order to avoid evaporative cooling and by applying a heating pad over clothing for 20 minutes after feeding.  If the vasospasm is caused by shallow latching, careful attention to positioning may also help.  If Raynaud’s is suspected and dry heat isn’t effective at eliminating pain, ask your physician if a medication called nifedipine may be helpful.

If you have sudden onset burning pain and shiny red or pink areolas and nipples, you may have a yeast infection.  Pain may also be sharp and stabbing.  If yeast is suspected, both mom and baby must be treated for two weeks past symptoms clearing.  While nystatin is commonly prescribed for baby’s mouth, studies show that it may not be effective.  In one recent study, it was only effective in 32% of cases, while fluconazole oral suspension was effective in 100% of the cases.  In some areas, a miconozole gel may be available from a compounding pharmacy.

Triple nipple ointment (APNO) is often prescribed for thrush on nipples.  If treatment continues for more than 2-3 weeks, consider a different preparation.  This ointment contains a steroid and prolonged use can lead to thinning of the skin. A recent study shows that virgin coconut oil is as effective as Diflucan for treating topical thrush.  Medihoney is another option.

An infant safe probiotic rubbed in Baby’s mouth and on the nipple may also be helpful in relieving the symptoms of thrush or bacterial infection.

Raw garlic can also be used to augment treatment of thrush or bacterial infection.  2-4 raw cloves are consumed per day.  Crush garlic and remove inner core.  Chop and let sit for 15 minutes or take right away if preferred.  Do not use medicinal garlic if you are on any blood thinning product, or have a clotting disorder, or are planning surgery.

Wash and sanitize anything that comes into contact with nipples or baby’s mouth if you have thrush.  Boiling is the preferred method.  Soak anything that cannot be boiled, in a solution of vinegar and water for 30 minutes.