From the Guidelines
A mother typically does not need antibiotics if her baby bites her nipple during breastfeeding unless there are signs of infection. Most nipple injuries from biting heal well with simple care measures. If the bite breaks the skin, clean the area with mild soap and water, apply a small amount of medical-grade lanolin or breast milk to promote healing, and let the nipples air dry after feedings. Continue breastfeeding, starting on the less painful side first. Signs that would indicate a need for antibiotics include increasing redness, warmth, swelling, pus, red streaks extending from the nipple, fever, or worsening pain after 24-48 hours. These symptoms suggest an infection that may require medical attention and possibly antibiotic treatment. Although the study 1 suggests the use of oral amoxicillin/clavulanic acid in breastfeeding patients with certain conditions, this is not directly applicable to nipple bites during breastfeeding. Infections occur because the human mouth contains bacteria that can enter broken skin, but most minor bites don't lead to infection if kept clean and dry. Key considerations for management include:
- Cleaning the area with mild soap and water
- Applying medical-grade lanolin or breast milk to promote healing
- Allowing the nipples to air dry after feedings
- Continuing breastfeeding, starting on the less painful side first
- Monitoring for signs of infection, such as increasing redness, warmth, swelling, pus, or fever.
From the Research
Antibiotics for Nipple Bites During Breastfeeding
- There is no direct evidence to suggest that a mother needs antibiotics if her baby bites her nipple during breastfeeding, unless there is a sign of infection, such as a positive culture for Staphylococcus aureus 2.
- The management of mastitis, which can be caused by sore nipples, includes changing breastfeeding technique and using antibiotics effective against Staphylococcus aureus, such as dicloxacillin or cephalexin, if necessary 3.
- Sore nipples can be caused by mechanical irritation, bacterial or yeast infection, or other factors, and the diagnosis of the underlying cause is important to determine the appropriate treatment 3, 2.
- The use of warm water compresses, keeping the nipples clean and dry, and expressed breast-milk may help to reduce nipple pain and prevent infection 2, 4.
- In cases where the baby's bite causes a wound, the use of breast shells and lanolin may be more effective than hydrogel wound dressings in promoting healing and reducing pain, and may reduce the risk of infection 5.
- It is also important to consider other causes of nipple pain, such as Raynaud's phenomenon, which can be treated with nifedipine, a calcium channel blocker that is safe to use during breastfeeding 6.