Breastfeeding - skin and nipple changes

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.
• 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.

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.

Contact your provider if you notice unusual changes in your skin and nipples. 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)

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

Newton ER, Stuebe AM. Lactation and breastfeeding. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Valente SA, Grobmyer SR. Mastitis and breast abscess. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 6.

Updated by: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.