Nipple pain almost always traces back to one of a few common causes: friction, a poor breastfeeding latch, hormonal shifts, skin conditions, or infection. The fix depends entirely on what’s triggering it. Most cases resolve quickly once you identify the source and make a targeted change, whether that’s adjusting how your baby latches, switching your running shirt, or treating an underlying skin issue.
Fix Your Breastfeeding Latch First
A shallow latch is the single most common reason for nipple pain during breastfeeding. When your baby clamps down on just the nipple instead of taking in a wide mouthful of breast tissue, the friction and compression can crack, blister, and bruise the skin within days. The good news is that correcting the latch often eliminates the pain almost immediately.
Start by positioning your baby so their chest and stomach rest flat against your body, with their head straight rather than turned to one side. Tickle your baby’s lips with your nipple to encourage a wide-open mouth, then aim your nipple just above the top lip and let your baby lead in chin first. The lower lip should land well below the base of the nipple, not right at it. When the latch is right, your baby’s lips flare outward like a fish, the tongue extends under the breast, and you feel a deep tugging sensation rather than a sharp pinch.
If you’re struggling to get this consistently, skin-to-skin contact can help. With both of you undressed from the waist up, hold your baby against your chest and let them find the nipple on their own while you support their neck, shoulders, and hips. This instinct-driven approach often produces a deeper, more comfortable latch than trying to force precise positioning.
Check Your Pump Flange Size
If you’re pumping and your nipples hurt, the flange (the cone-shaped piece that sits over your breast) is likely the wrong size. A flange that’s too small lets your nipple rub against the tunnel wall with every suction cycle. One that’s too large pulls excess areola tissue into the tunnel, causing swelling and soreness.
To find the right fit, measure the diameter of your nipple at its base (not including the areola), then add 2 to 3 millimeters. So a 16mm nipple needs a 19 to 20mm flange. A few important details: measure both sides, because they may differ. Don’t measure during pregnancy, since nipple size changes. And recheck around 10 weeks postpartum, because your size can shift once your milk supply stabilizes. When the fit is correct, your nipple moves freely inside the tunnel without dragging against the sides.
Treat Cracked or Damaged Skin
Once nipple skin is cracked or abraded, it becomes vulnerable to bacterial and fungal infection, which slows healing and worsens pain. A compound called All Purpose Nipple Ointment, originally developed by pediatrician Jack Newman, combines three ingredients to address this: an antibiotic to fight bacteria (particularly staph, which colonizes skin cracks easily), an antifungal to prevent yeast overgrowth, and a mild steroid to reduce inflammation and pain while healing takes place. This requires a prescription, so you’ll need to ask your provider to have it compounded.
For simpler cases of dry, cracked nipples without signs of infection, purified lanolin or a plain emollient applied after feeding keeps the skin moist and protects it from further friction. Letting nipples air-dry after nursing also helps.
Recognize a Yeast Infection
A yeast infection on the nipple (sometimes called nipple thrush) causes burning, shooting pain that continues between feedings, along with redness, itching, cracked skin, and sometimes swelling around the nipple and areola. If you’re breastfeeding, your baby may have white patches inside their mouth at the same time.
Risk factors include diabetes, a weakened immune system, and recent antibiotic use. Treatment typically involves a topical antifungal cream. In stubborn cases, an oral antifungal may be needed. Older remedies like gentian violet are no longer recommended because they can cause ulceration on your nipple and sores in your baby’s mouth.
Manage Nipple Vasospasm
If your nipples turn white or blue after feeding or when exposed to cold, then flush red with a burning or throbbing pain, you’re likely dealing with vasospasm. This is essentially Raynaud’s phenomenon affecting the nipple: blood vessels clamp down and temporarily cut off circulation, then painfully reopen.
Non-drug strategies work for many people. Warm your nipples immediately after feeding (a warm washcloth or cupping your hands over them), avoid cold exposure, manage stress, and cut out caffeine. Cold medications containing pseudoephedrine can also trigger vasospasm, so avoid those. If warming and lifestyle changes aren’t enough, a blood pressure medication that relaxes blood vessels is considered the first-line prescription treatment. It’s typically started at a low dose and increased gradually over a few weeks.
Handle Engorgement and Inflammation
In the early postpartum days, breast engorgement can make latching nearly impossible, which in turn damages nipples. The swollen, taut areola prevents the baby from getting a deep latch, so they end up chewing on just the nipple.
Before attempting to latch, try reverse pressure softening: press your fingertips gently around the base of the nipple for a minute or two to push fluid back and soften the areola. Hand-expressing a small amount of milk also helps. Ice packs between feedings reduce swelling. An over-the-counter anti-inflammatory like ibuprofen addresses both the pain and the underlying inflammation. Avoid aggressive pumping during engorgement, which can signal your body to produce even more milk and worsen the cycle.
If you develop a small white bleb (a tiny blister on the nipple opening), resist the urge to pop or “unroof” it. Current clinical guidelines recommend treating blebs with a moderate-potency steroid cream and oral lecithin supplements to reduce the surface inflammation and prevent recurrence.
Stop Friction From Exercise
Runner’s nipple, or jogger’s nipple, is caused by repeated rubbing of fabric against the skin during physical activity. Cotton shirts are particularly notorious for this because they absorb sweat, get heavy, and become more abrasive as they get wet.
Three strategies work well, and you can combine all of them. First, switch to lightweight, moisture-wicking synthetic fabrics that stay dry and smooth. Second, apply petroleum jelly or an anti-chafing balm directly to your nipples before a workout to create a lubricating layer. Third, place simple adhesive bandages or nipple covers over each nipple as a physical barrier. For longer runs or in wet conditions, the bandage-plus-lubricant combination is the most reliable approach.
Address Eczema and Dermatitis
Nipple eczema causes itchy, flaky, red skin on the nipple and areola. It can occur in anyone, not just breastfeeding women. Contact dermatitis from soaps, laundry detergents, or fabric can trigger it, as can atopic eczema that flares in other thin-skinned areas of the body.
Because nipple skin is thin and sensitive, only low to moderate potency topical steroid creams are appropriate. Apply a thin layer once daily, which is generally as effective as twice daily for most steroid strengths. Treatment usually lasts anywhere from a few days to six weeks depending on severity, but steroids shouldn’t be used on sensitive areas for extended periods without medical guidance. Switching to fragrance-free detergents and avoiding harsh soaps on the chest can prevent recurrence.
Hormonal Nipple Pain
Many people experience nipple tenderness that peaks in the second half of their menstrual cycle, typically in the week or two before a period. This happens because estrogen levels rise relative to progesterone during that phase, promoting fluid retention in breast tissue and stimulating cell proliferation. The result is swelling, heaviness, and heightened nipple sensitivity that resolves once menstruation begins.
If the pattern is predictable and mild, a supportive bra and over-the-counter pain relief during those days is often enough. For more disruptive cyclical pain, some providers recommend progesterone therapy to correct the hormonal imbalance driving the symptoms. Reducing dietary fat intake may also help, as higher fat consumption has been linked to more pronounced cyclical breast tenderness.
When Nipple Changes Need Evaluation
Most nipple pain is benign, but certain skin changes warrant a closer look. Paget disease of the breast is a rare form of cancer that mimics eczema, appearing as persistent itching, tingling, or redness of the nipple and areola along with flaking, crusty, or thickened skin. A nipple that gradually flattens or inverts, or discharge that’s bloody or yellowish, also raises concern. The key distinction from ordinary dermatitis is that Paget disease typically affects only one nipple, doesn’t respond to standard eczema treatments, and may be accompanied by a lump in the same breast. Any one-sided nipple skin change that doesn’t improve within a few weeks of treatment deserves further evaluation.