top of page

Nipple Death! Is this really a thing?

Updated: 4 days ago

So I was recently interviewed by freelance writer Ronny Maye for a few global news publications, INSIDER & YAHOO! on the topic of Nipple Necrosis, which means nipple death. The article went live today, see below for link and full interview...

A woman on TikTok said her nipple fell off while she was breastfeeding. It's very rare, do not be scared. If you are working with a lactation consultant you shouldn't encounter this issue ever, but this woman I believe had some preexisting factors and conditions like untreated nipple damage and possibly and underlying health condition that contributed to this horrific story.

I gave them my opinion and expertise on the matter, you can read it here:

Here's my full take on it, the interview with the amazing author, Ronny Maye.

1. What can cause something like this to happen? Can it be prevented?

Bilateral nipple necrosis in a breastfeeding person is a rare occurrence. Unilateral nipple necrosis can happen but is also uncommon amongst lactating people. When the nipple and its tissue don’t get enough blood flow, some of the tissue can die. This tissue breakdown is known as “necrosis” which translates to tissue death. When this type of trauma happens with chest/breastfeeding it should be considered that there could be an intensified inflammatory response from a preexisting known or unknown condition. For instance, Behçet's disease, is a rare disorder or syndrome that causes blood vessel inflammation throughout your body or Pagets disease which is a disease of the nipple most associated with some breast cancer diagnosis’. In the latter mentions, nipple damage is not 100% preventable, but generally speaking, there are absolutely things that can be done to mitigate the risk of nipple trauma. Other well known causes of nipple damage can be from breast pump misuse or trauma from poorly fitting flanges, excessive high pressure or even too prolonged duration of pumping. Dermatosis, infection, vasospasm/Raynaud’s phenomenon, functional pain–due to a stimulus that does not normally provoke pain, are some potential causes of breast and nipple pain which can result in damage.

Some of the basics include:
  • Going to a breastfeeding class to learn about what to expect and when to seek help with breastfeeding before things worsen.

  • Practicing proper latching techniques can be the biggest game changer when it comes to prevention.

  • Booking a lactation consultation with an IBCLC within the early days/weeks postpartum (1 - 4 weeks) to complete an evaluation which may include:

  • Oral assessment on the baby, weight check and weighted feed (to see how much your baby is transferring)

  • Visual inspection of your chest/breast

  • Observation of a feeding or pumping session

  • Medical history and birthing experience

  • Mental health evaluation (using a GAD-7 and/or EDPS)

  • General discussion of your goals and current situation to find problems and solutions

A special note on oral restrictions / tethered oral tissues (TOT) also known as Tongue Tie. This is a hot topic amongst medical providers, lactation professionals and parents. If you suspect your baby has a tongue tie, or just would like more information on it, I strongly recommend going to an IBCLC. They can do an assessment using a frenotomy or frenectomy tool, and send a report to your pediatrician. If necessary, provide you with a recommendation/referral to see a pediatric dentist or specialist who can diagnose and offer further treatment options. Tongue tie doesn’t mean your baby cannot breastfeed, it simply means you and your baby might need additional care and support in establishing and maintaining a successful and pain free chest/breastfeeding relationship. Tongue ties do not always cause pain, tongue tie ranges in degree of severity. It’s critical to discuss this with a skilled professional rather than self or “internet” diagnosing, Dr. Google is not always our friend. Do not panic if you are told your baby has a tongue tie because there are many options to resolve and/or manage it. Many times insurance may cover the cost of your visit to an IBCLC, so check your coverage!

2. Are there symptoms that mom can be looking out for that will indicate the risk of experiencing nipple trauma?

Many breastfeeding people complain of having breast pain, but it’s important to remember that breastfeeding shouldn’t cause pain or be painful. If it is, you should seek professional help as soon as possible. It can be particularly difficult for new parents in the early weeks to distinguish between pathological pain from discomfort, which the latter is common in the early days and weeks of beginning a chest/breastfeeding relationship. This due to the frequent stimulation that your chest was likely not receiving previously.

Poor latch is something any parent can be on the lookout for, since it’s one of the biggest indicators for nipple trauma. In order to avoid this risk of receiving nipple trauma due to poor latch, it’s critical to practice and learn proper positioning and deep latch techniques. If the baby is only latched onto the nipple they are causing lots of nipple trauma.