- Cleaning: You should clean your breasts with warm water at least once daily then dry it out with a clean towel. If your nipples are sore, a little expressed breast milk or purified lanolin can help; the main way to prevent cracking is a good latch. You should clean your hand well before breast feeding and also clean the nipples well before and after breastfeeding. If breast cleaning is not done well, it might end in inflammation of the milk ducts.
- Clothes: Avoid tight bras or bras with wire supports. Simple wide and cottons bras are preferred. No hard contact should be between your nipples and clothes and avoid using any irritating or allergic agents on your breasts.
- Nipple Cracks and pain: it is caused by the baby not latching on the nipple the correct way or due to inflammation. If the cracks or pain is so severe avoid breast feeding with the affected breast for a period time till your breast heals and in the meantime draw the milk out by gentle massage of the breast and not by suction. If you feel good start breastfeeding with the affected side again, but if your healing is slow consult a doctor.
- Breast congestion: You can gently massage your breast during breast feeding and you can also use warm clothes over your affected side before feeding. Try to breastfeed on close intervals to empty the breast. You can visit your doctor if the situation persists.
- Breast milk amount: If you feel that your breast milk is not enough you have to check with your doctor. Milk release depends on repeated sucking of the nipples and breast .When the baby sucks the nipple 2 hormones are released prolactin and oxytocin. The former is responsible for making milk and the latter is responsible for ejecting the milk.
Scientific Update (October 2026)
This chapter was first published in 2018 as part of the Prenatal Care Book, and has been reviewed and updated according to the latest guidelines. Key updates:
- Washing the nipples before and after every feed is not necessary; a daily shower is enough.
- Current guidance for engorgement and mastitis: keep feeding on demand, use cold compresses and painkillers, and avoid vigorous massage and over-pumping.
References: NICE postnatal care (NG194), WHO recommendations on antenatal care (2016).