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Possible Reasons for Sore Nipples When Pumping

Mom on bed pumping breast milk coping with sore nipples while newborn sleeps near her.

Many women think they have sore nipples due to pumping. That’s possible, and usually manageable. Let’s look at some reasons why it might happen, and some strategies to prevent or minimize the problem.

Just remember, sore nipples may be related to a suckling baby, too. But since we’re focusing on pump problems, let’s outline some possible explanations.

Possible Reasons

Here are four main reasons that directly relate to the pump.

Flange is too big

Here, the areola gets caught in the tunnel of flange. As a rule, if you can see any more than ¼ inch of areola in the tunnel of the flange, then the flange is probably too big.

 Pain is present. You should not have pain while pumping!

Flange is too small

Any discoloration of the nipple during or after pumping is concerning. The nipple becomes white while pumping, red, or purple after pumping.

A misshapen nipple is also concerning. Look and see if, after pumping, the tip of the nipple has a sort of angular shape — kind of like the shape of a new lipstick — rather than rounded.

Pain is present. Again, you should not have pain when pumping!

Suction was started on maximum

Discoloration of the nipple might be due to a high suction, rather than to the flange. (Although often, these problems happen concurrently.) 

As related to suction, people often presume that “more is better” or that they must achieve the pump’s highest suction level. Not so.

To avoid sore nipples when pumping,

  • begin using the minimum suction and work up gradually, depending on your comfort level.
  • increase suction gradually; for some mothers, it takes weeks or months to get to maximum levels
  • abandon the idea that you “must” use the maximum suction. Some mothers will never be ready for that — and that’s okay.

There is no real need to get to maximum suction. Your let-down reflex can become impaired if you’re not comfortable.

There’s a defect of some kind

Pump motors can and sometimes do wear out. If so, the suction is affected, causing sore nipples.

Not many people use a pump with a gasket these days, but I’m here to tell you that a worn-out gasket will affect the suction, and therefore, affect comfort. Sore nipples can result.

Any type of malfunctioning that alters the suction could cause sore nipples. This doesn’t happen very often, but it’s something you can’t entirely overlook.

How to overcome sore nipples when pumping

Don’t think you’ve got to put up and shut up. There’s almost always a solution to the problem. Here are some ideas.

Fix the issue

It probably goes without saying, but if you know what the problem is, fix it!

If signs point to a too-large or a too-small flange, get a different size.

Things get a little trickier if you’re not sure what the problem is. (And remember that some “sore nipple” issues are completely unrelated to the pump or pumping.)

However, here are some ideas to try.

Apply some olive oil to the flange

I’m a big fan of using olive oil on the flange. Just drip a little extra virgin olive oil into your finger — less than a dime-sized dot — and then rub your finger on the area right where the flare and the tunnel meet.

Rub some milk onto your nipples after pumping

I’m also a big fan of rubbing some milk onto the nipples after the pumping session is over. Now let me be quick to say that two different research studies have shown that milk on the nipples does not offer any special advantage.

However, research studies have never shown any harm in doing so. I truly believe that at some point, we will have better-designed research studies showing that indeed, this technique works.

Why am I so convinced? Well, we know that human milk contains several protective components — including anti-inflammatory and anti-infective properties — so it only stands to reason that these properties would have a positive effect on the nipple. And, in some cultures throughout the world, human milk is deliberately applied to multiple types of lesions because of its healing properties.

Finally, from anecdotal evidence, I feel reasonably confident that there’s a healing effect of human milk on the nipples.

Hence, with no evidence to show harm, I think that applying it to sore nipples when pumping is worth a try.

What doesn’t work

I’m not a fan of creams and ointments, except in extreme situations. I do believe there are situations where creams and ointments may offer some benefit, but these benefits have not been well proven, and some have been refuted entirely.

Perhaps a big point is realizing that if you don’t fix the root of the problem — say your flange doesn’t fit, for example — no amount of creams and ointments will do you any good.

Before you use any cream or lotion on your sore nipples when pumping, give some serious consideration to what you’re using.

Have you had sore nipples while pumping? What worked for you? Share your experiences in the comments below! 

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