All About Nipple and Breast Infections
Nipples are just skin, and like all skin, if there is a break in the skin, and bacteria gets in, there will be the possibility of an infection.
The trickiest symptoms of breast and nipple infections are the ones where we have pain and irritation of an indeterminate cause. If I have a client with pain we can’t attribute to the pump or the latch, I’m sending them off for lab work! Some infections in the milk ducts present with no outward signs and this can be a frequent cause of ongoing pain that is actually fairly easily solved by just culturing what is growing.
Sounds easy enough to identify, right? I mean, just look at every breastfeeding Facebook group, and you can see you don’t even need to see a doctor to be diagnosed, a random mom or admin can clearly tell you what it is and what to do about it without ever needing to see a doctor.
Yeah, that sounds absurd! It’s not that easy to accurately identify, and Dr. Facebook is not a great plan. I genuinely get the urge to get immediate help but it’s hard to watch this happen all 👏🏻 the 👏🏻 time 👏🏻 knowing this is only delaying that parent getting real help.
Signs of possible infection include:
Red Nipples
Pink Nipples
Shiny Skin
Flaky Skin
Increased Nipple Pain after Feed
Increased Nipple Pain towards the evening/night that improves overnight
Shooting Pains in the breast (sometimes described as pins and needles, or like glass)
Persistent cracks, fissures, and abrasions
Weeping wounds
Pus
Yellow Crusted Lesions
Cellulitis
Issues that present similarly but are not infections of the nipple skin:
Signs of Infection in the Breast:
Bilateral deep breast pain, could be dull aching or burning pain
Pain during and after breastfeeds
Breast tenderness particularly in the lower half of the breast
Redness of the breast
So why can it be tricky to identify a nipple infection?
Sometimes, we can look at the nipple and see an obvious infection. Sometimes, we have to look deeper and identify if it’s a condition with similar symptoms that isn’t an infection, or if it’s just a torn up nipple from a bad latch or flange fit. I’ve seen this type of manual trauma do a lot of damage without an infection in sight! The important part is not mistaking a benign issue for an infection and mistakingly treating with antibiotics you don’t need. The most popular treatment I am seeing right now for nipple pain and damage is All Purpose Nipple Ointment, also referred to as APNO. This cream gets credited with magical healing properties, but is easily misused.
Is APNO safe?
Yes. Is it a great thing for infected nipples? Yes! The best part is it treats bacterial and fungal infections at the same time!
But does it have risks? Yes it does. The steroid component can inflame skin, the antibacterial agent can cause good bacteria to die off inflaming a fungal thrush infection. And, it won’t do a darn thing for a manually damaged nipple unless we correct ALL of the reasons the damage happened in the first place.
Most concerning with the obsession of APNO is it being used for weeks or months on end. If you need antibacterial, anti fungal, steroidal treatment for more than a few days, there is a serious problem. APNO is medication, not regular old nipple balm.
What should you do if your nipples are painful and damaged?
Call a Lactation Consultant ASAP! The quicker we get involved, the sooner you will see resolution to your issues. We are trained to identify the most likely causes of the damage, create a care plan to resolve it, and to know when to refer to your health care provider. We can help you find the relief you need for a better breastfeeding experience.
