Cracked nipples and mastitis

A crack can develop when a baby attaches shallowly, when feeding is painful or when the nipple is exposed to friction and moisture. Mastitis is inflammation in breast tissue and may cause a hot, tender, swollen area, breast pain or feeling unwell. Nipple damage can make it easier for bacteria to enter, but not every crack leads to mastitis.

Pain may come from the nipple alone, breast inflammation, infection or another feeding problem. A clinician or lactation specialist can examine the breast and observe a feed to identify the likely cause.

Keep the nipple clean with water, let it dry, change damp breast pads and avoid harsh soaps. Check your baby’s latch and position; the nipple should not be pinched or compressed after a feed. A [Lactation Consultation](/treatments/pregnancy-and-birth-care/lactation-consultation/) can help with attachment and comfortable milk removal. Read more about [Breast Pain](/symptoms/breast-pain/) and [Painful Breastfeeding](/symptoms/painful-breastfeeding/).

Continue feeding or expressing if it is tolerable, unless a clinician advises otherwise. Use cool packs for swelling and ask a pharmacist or clinician which pain relief is suitable for you. Avoid squeezing the breast or using forceful massage over a tender area.

Contact a clinician promptly if redness spreads, breast pain increases, you develop fever or chills, pus appears, or you feel generally unwell. Seek urgent assessment for severe rapidly worsening symptoms. A crack that keeps reopening, bleeds repeatedly or does not heal also deserves review, as does a persistent breast lump.

Could my baby’s latch be causing the crack? Do I have mastitis or another cause of pain? Is treatment compatible with breastfeeding? How can I protect the nipple while it heals? When should I return if the redness or pain continues?