Breastfeeding - skin and nipple changes

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Description

Learning about skin and nipple changes during breastfeeding can help take care of yourself and know when to see a health care provider.

Alternative Names

Inverted nipple; Nipple discharge; Breast feeding - nipple changes; Breastfeeding - nipple changes

Notice Changes in Your Breasts and Nipples

Changes in your breasts and nipples may include:

  • Inverted nipples. This is normal if your nipples have always been indented inward and can easily point out when you touch them. If your nipples are pointing in, and this is new, talk to your provider right away.
  • Skin puckering or dimpling. This can be caused by scar tissue from surgery or an infection. Often, there is no known reason. You should see your provider but most of the time this does not need treatment.
  • Warm to the touch, red, or painful breast. This is caused by an infection in your breast. See your provider for treatment.
  • Scaly, flaking, itchy skin. This is most often eczema or a bacterial or fungal infection. See your provider for treatment. Flaking, scaly, itchy nipples can be a sign of Paget disease of the breast. This is a rare form of breast cancer involving the nipple.
  • Thickened skin with large pores. This is called peau d'orange because the skin looks like an orange peel. This can be caused by an infection in your breast or inflammatory breast cancer. See your provider right away.
  • Retracted nipples. Your nipple was raised above the surface but begins to pull inward and does not come out when stimulated. See your provider if this is new.

Take Care of Your Nipples

Your nipples naturally make a lubricant to prevent drying, cracking, or infections. To keep your nipples healthy:

  • Avoid soaps and harsh washing or drying of your breasts and nipples. This can cause dryness and cracking.
  • Rub a little breast milk on your nipple after feeding to protect it. Keep your nipples dry to prevent cracking and infection.
  • If you have cracked nipples, apply 100% pure lanolin after feedings.

When to Call the Doctor

Call your provider if you notice:

  • Your nipple is retracted or pulled in when it was not that way before.
  • Your nipple has changed in shape.
  • Your nipple becomes tender and it is not related to your menstrual cycle.
  • Your nipple has skin changes.
  • You have new nipple discharge.

Your provider will talk to you about your medical history and the recent changes you have noticed in your breasts and nipples. Your provider will also do a breast exam and may suggest that you see a dermatologist or breast specialist.

You may have these tests done:

  • Mammogram (uses x-rays to produce pictures of the breast)
  • Breast ultrasound (uses sound waves to examine the breasts)
  • Breast MRI (uses powerful magnets and radio waves to create detailed pictures of the breast tissue)
  • Biopsy (removal of a small amount of breast tissue to examine it)

References

Newton ER. Lactation and breastfeeding. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 24.

Swartz MH. The breast. In: Swartz MH, ed. Textbook of Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 13.

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