Is breastfeeding supposed to be painful?
Breastfeeding is often viewed as a perfectly natural process, but for many new mothers, it can bring unexpected pain and discomfort.
While breastfeeding should ideally be a pleasant and pain free experience, several issues can cause pain.
If you’re a mom to be, you may be wondering whether you should expect pain while breastfeeding. If you’re already a breastfeeding mother, you may be experiencing pain and you may be wondering whether this is normal.
Is breastfeeding painful?
One of the biggest breastfeeding myths is that painful nipples while breastfeeding is normal in the first few days and the first week as your nipples adjust to the stimulation, some even say it’s normal to have pain for the entire first month of breastfeeding. But this isn’t true.
Some nipple sensitivity in the very early days of breastfeeding may be expected, it will usually only last for a short few seconds after the initial latch and the sensitivity should subside within a week or two.
Nipple pain and painful breastfeeding is not normal. It’s very common, but that doesn’t make it normal. Nipple or breast damage and pain is a very clear sign that there’s an issue that needs to be assessed and treated.
Never push through the pain, you shouldn’t even be in pain and pushing through it will only make things worse. Reach out for support from an International Board Certified Lactation Consultant (IBCLC), to get you assessed and supported as soon as possible.
Causes of painful breastfeeding
Improper latch and positioning
Causes
An improper latch is one of the most frequent causes of breastfeeding pain.
For effective feeding, the baby needs to take in a mouthful of breast tissue along with the nipple.
A shallow latch, where only the nipple is grasped, can lead to pain, nipple damage, and ineffective milk transfer. All causing even more problems for the future.
Poor positioning can also contribute to nipple pain and damage, as both the mother and baby need to be in comfortable, well-supported positions to enable a good latch.
Sometimes it’s an easy latch or positioning fix by holding your baby differently, or learning how to help your baby latch on deeply.
Other times it may be a bit more complicated and can include oral/anatomical issues such as a tongue tie, a severely recessed jaw or other issues in either mother or baby.
Solutions
Positioning techniques
Experiment with different breastfeeding positions like laid back breastfeeding, cradle hold, football hold, or side-lying position to find what works best. Ensure that your baby’s body is aligned, with their head, neck, and spine in a straight line, facing the breast.
Seek professional help
Lactation consultants are trained to help new mothers achieve a proper latch.
They can help assess and support you with any different breastfeeding complications and will know when to refer you to other health care professionals for the best support possible.
Many hospitals and community centers offer lactation support, and organizations like La Leche League can also provide guidance.
Look for cues
Signs of a good latch include the baby’s chin touching the breast, lips flanged out, and seeing or hearing the baby swallow milk. If the baby’s cheeks look indented, they may not be latched deeply enough.
Teething
Causes
Teething usually begins between 4-7 months, although it can vary between each individual baby.
As a baby’s teeth start to emerge, their gums can become sore, which may cause them to clamp down on the nipple while nursing. This biting may obviously lead to significant discomfort for the mom.
Solutions
Respond calmly
When your baby bites, it can be instinctual to react with a loud noise. But this can startle your baby and this can sometimes lead to nursing aversion/breast refusal. So, instead, calmly remove your baby from the breast.
Use teething toys
Offer teething rings or cold washcloths for the baby to gnaw on before nursing. This can help relieve gum discomfort.
Offer something cold
Offer your baby something cold to chew on before breastfeeding as cold helps with pain and inflammation and will reduce the risk of your baby biting you during a feeding session.
Remember to keep it age appropriate. Frozen breastmilk or fruit are wonderful options to offer to your baby.
End the session if biting persists
If your baby bites repeatedly, stop the nursing session temporarily. Babies can learn to associate biting with the end of nursing, which may help reduce the behavior.
Gently remove them and tell them not to bite, as biting hurts and then try to latch them again. Babies are extremely intelligent, and they will quickly learn that breasts are not for biting.
Thrush
Causes
Oral Thrush and nipple Thrush is a yeast infection caused by the fungus Candida albicans and can affect both the baby’s mouth and the mother’s nipples.
It often presents with painful, itchy, or burning sensations in the nipples, and you may also notice white patches inside of your baby’s mouth.
Solutions
Antifungal treatment
Thrush should be treated with antifungal medications prescribed by a healthcare provider. Both mother and baby need to be treated simultaneously to prevent reinfection. Even if just one of you are showing symptoms.
Practice good hygiene
Regularly sterilize bottles, pacifiers, and breast pump parts. Washing bras, breast pads, and other items that contact the breast can also help prevent thrush from spreading.
Dietary adjustments
Reducing sugar intake and incorporating probiotics can support the body in fighting off yeast overgrowth. Always speak to your healthcare provider before making any drastic dietary changes.
Breast engorgement
Causes
Engorgement occurs when the breasts become overly full, usually due to a sudden increase in milk supply or infrequent feedings.
This can make the breasts feel hard, tender, and swollen. Engorgement can also flatten the nipple, making it challenging for the baby to latch properly.
Solutions
Frequent feedings
Breastfeeding frequently or expressing milk can prevent engorgement. Aim to nurse or pump at least every 2-3 hours if your baby doesn’t demand that.
Cold compresses
Applying a cold compress after nursing can reduce swelling and inflammation, helping with the pain.
Hand expression
If your breasts are too engorged for your baby to latch comfortably, gently hand express a small amount of milk to make it easier for your baby to latch.
When you feel uncomfortably engorged, you can hand express just enough for comfort as it will also help reduce the risk of blocked milk ducts and mastitis infections.
Reverse pressure softening
Before reaching for nipple shields, which can cause many issues if used incorrectly, give reverse pressure softening a try.
Blocked milk ducts
Causes
Blocked milk ducts or plugged milk ducts are inflammation of the breast. You’ll often be able to feel a tender lump in one of your breasts. Often caused by engorgement or milk stasis, restrictive bras and clothing, severe stress and pressure on the milk ducts.
Solutions
The new mastitis protocol recommends treating it as follows:
Breastfeed responsively
Breastfeed responsively and on demand from both breasts. Do not breastfeed to empty the breasts as we don’t want to encourage a higher supply unless it’s necessary.
Anelgesic use
Ibuprofen and Paracetamol can be used together to help with the pain and inflammation.
Ice
Cool compresses on the breasts whenever you feel it’s necessary will help with any pain and inflammation.
Lymphatic massages
Lymphatic massages are also recommended in the treatment of blocked milk ducts and mastitis.
Mastitis
Causes
Mastitis is a breast infection, often caused by blocked milk ducts or bacteria entering through cracked skin on the nipple.
It will often present with many symptoms including red streaks on the breast and flu-like symptoms. It can lead to flu-like symptoms, including fever, chills, and a painful, red, swollen area on the breast.
It’s important to treat mastitis correctly and promptly as it can lead to further complications such as a breast abscess.
Solutions
Breastfeed responsively
Breastfeed responsively and on demand from both breasts. Do not breastfeed to empty the breasts as we don’t want to encourage a higher supply unless it’s necessary.
Anelgesic use
Ibuprofen and Paracetamol can be used together to help with the pain and inflammation.
Ice
Cold compressions on the breasts whenever you feel it’s necessary will help with any pain and inflammation.
Lymphatic massages
Lymphatic massages are also recommended in the treatment of blocked milk ducts and mastitis.
Consult a doctor
Mastitis doesn’t always require antibiotics. But when symptoms don’t improve within a day or 2 with homecare, or if your symptoms worsen, you may need to consult with your medical provider.
A healthcare provider may prescribe antibiotics if symptoms persist, so it’s essential to seek medical attention when it’s required.
Milk Bleb (Milk Blister)
Causes
A milk bleb, also known as a milk blister, is a small white spot on the nipple that occurs when a milk duct opening becomes blocked. There can sometimes be multiple white spots, but this shouldn’t be mistaken for Thrush, which is usually more patchy.
It can cause sharp, localized pain during breastfeeding, often described as a burning sensation.
Solutions
Warm compresses and soaks
Applying a warm compress or soaking the nipple in warm water before feeding can help soften the blockage.
Gentle exfoliation
After soaking, gently rub the area with a soft washcloth to help clear the blocked pore. Do not force it; if the bleb persists, it may require medical attention.
Olive oil application
Applying a small amount of olive oil to the nipple between feedings can help soften the skin and keep the duct opening clear.
Aspiration by needle
If all else fails, you may need to consult with your doctor to perform an aspiration by needle to treat the milk bleb.
Vasospasms
Causes
Vasospasms refer to the constriction of blood vessels in the nipple, often triggered by exposure to cold or trauma, such as an improper latch.
This causes the nipple to turn white or blue and is often accompanied by a burning or throbbing pain.
Vasospasms are especially common in mothers who have Raynaud’s phenomenon.
Solutions
Warmth application
Keep the nipples warm by wearing layers and using a warm compress after feeding. Avoid exposing the nipples to cold air immediately after nursing.
Check for latch issues
An improper latch can increase the risk of vasospasms due to nipple compression. Consulting with a lactation consultant to help you improve the latch quality may reduce any trauma to the nipple.
Consider medical options
In severe cases, a healthcare provider might suggest medications that help dilate blood vessels to improve blood flow and reduce vasospasm episodes.
If other remedies are not working, or if the pain is severe, consult with your doctor to discuss any treatment options that you may have.
The let-down reflex
Causes
The letdown reflex comes in many different sensations. Some women never feel their letdown while others may have a rather painful letdown.
This can be normal if there’s no other issues with breastfeeding. Engorgement is known to cause a painful letdown too.
Solutions
There isn’t much you can do for different sensations of your letdown. If the cause of the painful letdown is due to engorgement, you can manage the engorgement, which will then improve the painful letdown.
Hormonal changes
Causes
Hormonal changes during ovulation, menstruation and pregnancy can cause nipple sensitivity or soreness.
Solutions
Unfortunately, there isn’t much we can do for hormonal causes.
Magnesium supplements have been said to help with nipple sensitivity. Always consult with your medical provider before taking new supplements or medications
We can also look at coping techniques such as breathing and distraction to get through sessions, or even things like partial weaning in severe cases.
Other general tips for managing breastfeeding pain
Use breast milk
Studies have shown that breastmilk is just as, if not more effective at healing cracked and damaged nipples as Lanolin cream is.
It’s full of antibacterial and healing properties and it’s completely free.
Put some on your nipples as often as you’d like and allow it to air dry.
Use Lanolin creams
Lanolin or other safe nipple creams can soothe cracked or sore nipples.
It’s important to note that this is not a solution, this is only to help soothe cracked and sore nipples while working on a solution.
Hydration and nutrition
Staying hydrated and eating a healthy and balanced diet supports your health, milk production and the body’s ability to heal.
Rest and stress management
Managing stress is very important, as physical discomfort from breastfeeding may be compounded by stress or lack of rest.
Practicing relaxation techniques, getting enough sleep, and seeking support can positively impact breastfeeding.
Reach out for support
La Leche League International (LLLI)
La Leche League International (LLLI) provides support through local groups, leaders, peer counsellors and online resources, offering encouragement and expert advice for breastfeeding challenges.
E-Lactancia
E-lactancia is a completely free resource where you can check the safety of most medications while breastfeeding.
Breastfeeding support groups
Breastfeeding support groups are a wonderful resource and support system for breastfeeding mothers. It helps different breastfeeding mothers relate and support each other. A breastfeeding community is very helpful and a wonderful resource for emotional support.
Each country and region will differ, but chances are, there’s some sort of breastfeeding support group that you can attend nearby. Or if not, there are plenty of virtual breastfeeding support groups too.
Breastfeeding peer counsellors and lactation counsellors
Breastfeeding peer counsellors are usually breastfeeding mothers who have a few hours of breastfeeding education. They can help with trustworthy information and resources.
Lactation counsellors have a lactation certificate which enables them to educate and support you with common breastfeeding issues.
International Board Certified Lactation Consultant (IBCLC)
A lactation consultant is a breastfeeding specialist, they have higher education and training enabling them to help assess and support parents with both basic and complex breastfeeding complications.
Lactation consultants can be found in the hospital, doctors’ offices, in the community services and in private practice.
Important notes on painful breastfeeding
Breastfeeding may be slightly painful initially or during certain stages, but damaged and painful nipples and breasts are not normal. It’s a sign of an issue.
Most breastfeeding issues are only temporary and easily manageable with the right support and care. So be sure to reach out for support as soon as you can.
Every mother’s breastfeeding journey is different and it’s important to remember that discomfort does not have to be part of your breastfeeding experience and journey.
With the correct information and the support of an International Board Certified Lactation Consultant (IBCLC), a pro breastfeeding health care provider and breastfeeding support groups, you can find ways to overcome most breastfeeding issues and enjoy the rewarding experience of breastfeeding your baby.
Additional information and resources
Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments
