Nipple piercings and breastfeeding

NIPPLE PIERCINGS

Will nipple piercings impact breastfeeding? Every body is different in how it reacts to taking out the jewelry out prior to breastfeeding. Just like with pierced ears, some of us will have the hole scar closed, the scar may partially close, or it could stay open for years and never have a problem sticking jewelry in and out at whim. Often the longer the time since the piercings were initially placed the better the outcome as the nipple has had time to properly heal. Common concerns may include nerve damage that impacts milk let down or scarring that prevents the milk from leaving the nipple. On the other hand, the extra holes created by the piercings could lead to a faster milk flow! (which some infants struggle to manage while others do just fine with). If the nipple pores have scarred shut, the breast may be able to make milk but it may not be able to exit from the nipple. This can lead to plugged ducts and mastitis. If the nerves have been damaged, the breast may make milk in the early days or weeks after delivery, but without the nerve impulse the breast will make less and less milk with time, even with all the herbs and quality pumping and efficient baby. Because our bodies are not perfectly symmetrical, some may have a problem on one side and not both. Some have no problem at all. We don’t know what your body is going to do and it cannot be predicted prior to birth. If your

Breastfeeding with the nipple jewelry in place is never recommended as it can make it difficult for the infant to latch-on correctly, increases the risk of choking on loose or dislodged jewelry, and can damage the inside of the baby’s mouth. If you are going to take your jewelry in and out every feeding, make sure you are being extremely careful with hand washing and jewelry sanitizing to reduce the risk of infection. Best practice says take the piercings out for the entirety of your breastfeeding journey. Many go on to successfully with pierced nipples, but if you’re having any problems or concerns, see a lactation consultant such as myself. For more of my thoughts on nipple piercings and breastfeeding, click here to check out my YouTube video

Nipple Damage: Now What?

It’s normal to experience nipple tenderness for the first few days after delivery. Tenderness peaks between the 3-6th days postpartum and then should resolves by the end of the second week. Any damage to the skin of the breast or nipple should be taken care of immediately to avoid further damage or infection.

Painful breastfeeding is not normal.  The first step to decreasing pain while breastfeeding is to identify what’s causing it. Usually the simplest way to reduce nipple pain is to make sure baby is in the right position. Baby’s tummy should be touching mom’s body, with the belly button touching. Baby’s arms hug the breast and their face comes straight to the nipple. Baby’s Head should be straight, with their ear, shoulder and hip making a straight line. Their head should be slightly extended backward to allow the nose to pop up off the breast. Pulling baby in closer through the shoulders usually helps get a deeper latch.  If nursing is still painful, even with careful attention to latch and positioning, there may be other things at play. Usually there is a tongue/lip tie, tension in baby’s body like from a long labor and delivery (greater than 24 hour labor and/or more than 4 hours of pushing), or tension on baby’s body from intrauterine position (sitting really low for a large portion of pregnancy or being breech). Having the tongue tie released and/or doing tummy time and bodywork on baby should resolve the pain. If you’re working on release and baby’s body, consider the temporary use of a nipple shield to protect nipples, until damage is resolved and the underlying cause of the damage is managed.

When your nipples are already damaged:

Step one: Wash and Rinse Damaged nipples are prone to bacterial infection. Washing and rinsing damaged nipples can help prevent this type of infection. When bacteria grows in a wound, they create a bio-film that lengthens healing time. Baby’s saliva also fosters this bio-film. Washing cracked or fissured nipples gently twice a day with a gentle, fragrance free soap (not an antibacterial soap) and rinsing them with water can help remove the bacterial bio-film and allow faster nipple healing. Stop washing with soap once the nipples are healed. After every feed, rinse nipples with either clean water or a saline rinse. You can make your own saline rinse by mixing ¼ rounded teaspoon of sea salt with 8 ounces of warm water. Soak your nipples in this solution for 30-60 seconds. Soaking for longer may actually over hydrate your skin and increase cracking.

Step Two: Moist Wound Healing after washing and rinsing and/or soaking your nipples, dry and apply your antimicrobial ointment of choice. This could be virgin coconut oil, Dr Jack Newman’s All Purpose Nipple Ointment, or medihoney. There are other nipple balms and butters on the market. Make sure the one you’re using is antimicrobial. While you may think airing the nipple out will help scab the nipple over, Keeping cracks covered with some type of ointment promotes moist wound healing which is better for the sensitive nipple tissue which is a different kind of tissue than the rest of your skin. A non-stick wound pad, reusable breast pad, or a cooling breastfeeding gel may be placed over the ointment to keep your nipples from sticking to your bra or clothing. Ointment should be applied like chapstick, in a thin layer. Gently wipe off any leftover ointment before baby feeds. Disposable nursing pads should be avoided as these do not allow for good air flow and the quick wicking material tends to stick to nipples. Wool breast pads are preferable for their antibacterial and air flow properties.

Monitor for Infection Contact your primary caregiver physician and an IBCLC lactation consultant if you have any signs of infection like increasing redness, fever, or pus. If you have a fever of 100 degrees or greater for 24 hours, or bacterial infection which will require oral antibiotics. Research suggests that taking probiotics containing lactobacillus fermentum and lactobacillus salivarius can also help treat bacterial infections of the breast.

Nipple shields

Not all nipple shields are created equal. Nipple shields are a great tool that can be used to help baby latch and stay latched, help you heal from nipple damage or trauma, or transition baby back to breast from using a bottle. Nipple shields are a great tool and can be used as long as needed. There are risks to long term use, the biggest one is a decrease in milk supply if baby isn’t able to trigger let downs or remove milk efficiently. If you weren’t given a plan for transitioning off the shield, a qualified lactation consultant can help!

Nipple Damage

Nipples and penises have a lot in common. From an anatomical, cellular level, they are both made of the same elastic, erectile tissue. They erect and evert with stimulation. They can crack, bleed, and blister, but they can never toughen up or callous. And neither one should ever crack or bleed.

Babies mouths have two areas: the hard, bony palate up front and the soft palate at the back, just in front of where that little hangy downy uvula is. One of the reasons a nipple erects, everts, and stretches is to help to get it in the safe zone where the palate is soft.

When a baby is latched correctly, the nipple tip stretches back to where the palate is soft, then the tongue massages the nipple to express milk. If baby has a shallow latch, the tongue pinches the nipple tip against the hard roof of the mouth and causes damage. This also happens when there is a tongue tie where the tongue is restricted in its movement. Instead of the middle of the tongue massaging the nipple, the the tongue is anchored to the floor of the mouth and it flicks the nipple, or the middle of the tongue where the restriction is pinches the nipple against the bony palate.

Nipples are perfectly designed to withstand breastfeeding. Other than temporary tenderness in the first few days, there should be no pain or damage. If you do get damage, they should heal quickly (within 24-48 hours) if you can get a consistent deep latch.

Moist wound healing is most effective to heal a nipple. Tips to heal a damaged nipple:

💡Keep breast milk on the nipple. Using a washable breast pad can help keep milk on the nipple

💡Nipple balms/butters, coconut oil and lanolin can help keep the nipple from sticking to clothing and feel soothing

💡Breast gels

💡A 20 second saline rinse once or twice a day

💡Soak the nipple in an Epsom salt bath, either in a bowl or Haakaa filled with warm water

💡A prescription for Dr Jack Newman’s All Purpose Nipple Ointment for severely damaged nipples

💡Silverette cups for persistent damage

💡Temporarily use a nipple

💡Schedule a lactation consultation time get to the root of the damage

Silverette Cups to heal moderate to severe nipple damage