Cracked Nipples

Sore nipples when starting breastfeeding is normal, and as the nipples adjust to breastfeeding, the pain should subside. Sometimes however, nipples may blister, graze or crack due to:

  • Mother and baby still learning how to feed
  • Baby sucking strongly
  • Sensitive nipple tissue
  • Cluster feeding which doesn’t give the nipples time to rest

Management of cracked nipples includes:

  • Laser therapy to help speed up the natural recovery process. If your nipples are cracked, grazed or blistered, your physiotherapist can provide this treatment. It is pain-free, has no side-effects and does not interfere with breastfeeding
  • Application of Lansinoh cream (which can be bought at the chemist over the counter) effective in hydrating nipples and reducing further cracking

Blocked milk ducts and Mastitis

Mastitis is usually the result of a blocked duct that has not cleared; this can lead to inflammation. Factors which may lead to mastitis include:

  • Poor drainage of the breast or delayed/missed feed
  • Tight or ill-fitting bra or underwire digging in
  • Holding breast too firmly during feeding or massaging too firmly
  • Trauma such as a kick from a toddler or pressure from a seatbelt
  • Nipple trauma
  • Poor breast hygiene

Management of blocked milk ducts includes:

  • Optimising breastfeeding to maximise drainage.
  • Applying a heat pack or having a warm shower prior to feeds to facilitate milk flow
  • Applying a cold compress after feeds for comfort
  • Gentle light massage strokes with flat fingers from beyond the blockage towards the nipple to help relieve blockage. Note – heavy strokes can cause bruising and further swelling.

If flu-like symptoms are experienced, seek medical help. If the doctor believes it is an infective mastitis, antibiotics will be prescribed first.

Management of mastitis can includes:

  • Continuing to breastfeed whilst on antibiotics. Baby may experience a few runny nappies but it will not cause harm
  • Ultrasound treatment once antibiotics have been taken for 24 hours
  • Application of cold compresses after feeds
  • Resting and maintaining adequate fluid intake
  • Analgesia for pain relief as required

Breast engorgement

Breast engorgement is common for women as a precursor to the milk coming in 1-4 days after birth. Breasts often feel full and uncomfortable.

Management of engorgement:

  • Warm showers and warm compresses over breasts before feeds to assist milk flow
  • Cold compresses over breasts after feeding for comfort

Therapeutic ultrasound treatment can be very effective if the blockage has not cleared within 8-12 hours. If you require any laser or ultrasound therapy, please ask at reception or call today on 9382 9600 and request an appointment with one of our women’s health physiotherapists:

Mansi Aghera
B.Sc. (Physio), GradCert Continence and Women’sHealth

Carolyn Bendall
B. App Sc. (Physio)


  • Postnatal Breast Care

    SportsMed Subiaco physiotherapists can provide inpatient and outpatient treatments for the following common breast issues after giving birth.

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