Along with other breast disorders, such as engorged breasts and mastitis, cracked nipples are one of the major causes of breastfeeding failure. Cracked nipples are thin, superficial lacerations (small cuts) of the skin or mucous membranes of variable depth, which can affect both the nipples and the areola, or the pigmented skin area that surrounds it.

Although there are few works, present in the scientific literature, that describe the dermatological lesions of the nipple during the first week of nursing, the formation of cracks in women who are breastfeeding is quite high and varies between 65% to 76%.

In the first days after birth, a large number of mothers has a mild pain in the region of the nipple when the baby latches on and starts sucking, simply due to the slowness of the milk flow output.
In order to increase the milk flow output produced by the mammary gland, in fact, it is necessary that this be stimulated by oxytocin (the production of which is activated by the stimuli exerted on the nipple) and that the baby properly latches on.

Figure 9: Different cracked nipples

Until these two conditions occur, the breast will be subjected to stress, but as soon as the child will latch on adequate, nursing will no longer hurt. If the pain persists, however, due to bad positioning of the infant, damage will be caused by friction of the skin of the nipple, resulting in cracked nipples. These wounds of the skin tissue may have different shapes based on the location of the lesion: curvilinear (around the base), branched or rectilinear (located on the tip of the nipple) (Fig. 9).

This small tissue damage, causes pain during feeding and is experienced and endured in different ways by mothers, often causing a reduction in the number and duration of feedings with the onset of problems such as:

  • Incomplete emptying of breast milk and subsequent engorgement
  • Insufficient stimulation reflected by the production of prolactin with low milk production.

CAUTION: Cracks are a point of entry for bacteria, which in the case of the simultaneous presence of engorgement, may cause mastitis.