Cracked nipples or fissures may sometimes occur in women who are breastfeeding. Actually, young mothers may be surprised to find breastfeeding feels more complicated, awkward, or even painful than they expected. Breastfeeding is a learned skill for mothers and it can take some time to get the hang of it. Uncomfortable breastfeeding positions can cause your baby to squash the nipple as they feed, leading to cracked and painful nipples.

Cracked nipples: What you can do about them

There are a number of things you can do to treat cracked nipples:

• Wash your nipples with water after every feed and clean and sterilise your nipple shield after each feed.

• Take special care with positioning and attachment.

• If you can, continue breastfeeding (it is quite safe for baby to feed on a bleeding nipple).

• If it’s too painful, you may need to take a break for 24 to 48 hours, let the nipple rest and feed your baby with expressed breast milk.

• Gradually reintroduce the breast after resting for a short time.

If you aren’t breastfeeding

If you aren’t breastfeeding, but have cracked nipples, it can be a sign of other health conditions or even dangerous illnesses.

• Contact dermatitis happens when your skin comes into contact with an irritating substance, either a new soap, laundry detergent, or an industrial cleaner on a new bra.

• Allergic reactions can also cause nipple fissures. These allergens can be chemicals or fragrances in products such as laundry detergents, shampoo or conditioner, perfume, lotion or moisturizer, etc. If you notice irritation and nipple fissures after applying a certain product, it is possible that your skin is sensitive to the chemicals or fragrances in that product.

• As a result of dry skin from exposure to cold and heat. Your nipples may be dry and cracked because of exposure to hot water in the shower. This irritation can be made worse by tight-fitting clothing. Other symptoms may include itchiness, blisters, scaly skin, or rashes.

• A new nipple piercing takes two to four months to heal, during which time, it may bleed. Infections, which can develop both during and after healing, can also cause a collection of pus (an abscess) to form inside the nipple or areola.

• Mastitis is a breast infection that may have cracked nipples as one of the symptoms together with fatigue, fever, breast pain, breast redness, swelling. Mastitis most commonly affects women who are breastfeeding (lactation mastitis), although sometimes this condition occurs in women who aren't breastfeeding.

Cracked nipples are an emergency if accompanied by a pus-like discharge from the crack in the nipple, breast redness, a change in the skin texture resembling orange peel, fever, and pain in the breasts.   

You should watch out for cracked, damaged nipples, as they provide an entry point for bacteria, which can lead to a mastitis infection.