Why + how to fix your pain during breastfeeding

Pain during breastfeeding
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Pain during breastfeeding doesn’t just hurt physically—it can weigh on a mom’s mind emotionally, too. But if you’re having pain during breastfeeding, don’t be too quick to call it quits. As Jennifer Abdul-Rahman, BSN, RN, IBCLC helps explain, it’s possible to breastfeed comfortably and happily.

Breastfeeding isn’t always effortless at the start, and that’s OK

Settling into life as a new parent can be incredibly overwhelming. There’s so much about welcoming a newborn into your heart and home that is beautiful—and also exhausting. Many newborns love to feed around the clock. Keeping up with 8 to 12 feedings (or more!) a day can be tiring. That’s especially true if you’re wanting to nurse but are having pain during breastfeeding or other concerns as you try to do it.

It can help to know that breastfeeding is a challenge for a lot of moms—new and experienced. In fact, one survey found that 92% of moms deal with breastfeeding issues by day 3. Struggling doesn’t change the fact that you’re an amazing parent. Because breastfeeding is a skill that needs to be learned by parents and baby, we highly recommend working with a board-certified lactation consultant. They’ve seen it all and can equip you with the knowledge to overcome challenges.

Common reasons for pain during breastfeeding

Sore and tender nipples

Breastfeeding is a new sensation for many moms. It’s hard to know what it’s supposed to feel like and what’s normal or not. Jennifer Abdul-Rahman, BSN, RN, IBCLC and founder of Latched Eternal, says, “Nipple soreness is common in the early days and may last a few weeks. When baby is feeding, though, the latch should feel comfortable—like a strong pull or a tug.”

Quote: "Nipple soreness is common in the early days and may last a few weeks. When baby is feeding, though, the latch should feel comfortable---like a strong pull or a tug."

She tells new moms, “Pain while breastfeeding is common but not normal, and steps should be taken to resolve pain. If repositioning, re-latching, or trying a different latch technique is not working, reach out to a lactation consultant sooner rather than later. A burning, stabbing, pinching, throbbing pain is a sign that the latch needs improvement.”

Some women also experience cracked nipples—which may cause some pain during breastfeeding. To offer help to cracked nipples, make sure your nipples are dry before snapping up your bra or getting dressed, and change your nursing pads after every feed. Expressing some breast milk and rubbing it onto the nipple and areola (which is the circular dark skin around your nipple) can also help.

Is it okay to breastfeed with cracked nipples?

“Yes, it is okay to feed with cracked or bleeding nipples,” Jennifer says. “It is common for shallow latches to occur in the early days, as you and baby both learn how to breastfeed. That can result in nipple pain, tenderness, bruises, cracks, or bleeding.”

“The nipple will continue to heal with continued latching if the latches become deep,” she explains. “The first suck is always the most uncomfortable. If the pain resolves after the first 20–30 seconds, then that is an indication the latch is now deep, and the nipple is far enough back in the mouth that it is protected.”

Strong milk letdown reflex

Especially in the first month of breastfeeding, it’s possible to experience discomfort at the start of a feeding but that goes away as your baby nurses. This can be due to a strong milk letdown reflex. Every mother’s letdown reflex is different. For some women, the process happens slowly, and they may need to hand express a little milk before baby latches on. For others, it’s quick. During a strong letdown reflex, your milk rushes down through your milk ducts. As the milk ducts stretch to accommodate the flow of milk, some women feel tingling or temporary pain and discomfort. Adjusting to breastfeeding usually helps this feeling.

If you continue to have pain during your milk letdown reflex, let your lactation consultant know. Jennifer, BSN, RN, IBCLC, says that your consultant will want to see where exactly the pain is occurring. “There is a very large nerve that runs along the outside of the breast and innervates the nipple. This is often the cause of this [letdown] type of discomfort, and it will lessen over time.”

“We will also look for signs of color change to the nipple and anywhere else in the breast you may be experiencing pain, as Raynaud’s of the nipple can also cause a similar pain. We will check your baby’s latch to ensure it is a deep latch and that baby is sucking effectively.” She adds, “We may also check the shape of the nipple after your baby feeds and assess baby’s mouth for any possible oral restrictions. Clogged ducts and mastitis can also cause a similar pain, so we would assess for those symptoms too.”

Incorrect latch

Many times, breastfeeding pain and how your baby is latching go hand-in-hand. A good first step to take is to try and reposition yourself and your newborn. The best way to do that? Jennifer explains, “This can vary for a lot of people. Parents with large breasts may prefer side-lying or football (clutch) position. Cross cradle can work, as long as baby is supported really well with lots of pillows.”

What if neither of those are comfortable? “Those who have had a c-section may prefer a laid-back hold or football hold,” Jennifer says. “The three key points to remember—no matter the position—is to use pillows to elevate baby’s whole body to the level of the breast, make sure baby is belly-to-belly with the head facing the breast, and make sure the nipple is towards the nose.”

3 Key Points to Breastfeeding Position: elevate baby's body to the level of the breast, make sure baby is belly-to-belly with the head facing the breast, and make sure the nose is toward the nipple

Just how important are these keys to positioning? “I just attended a conference where they discussed that, in 72% of cases, proper positioning may correct a shallow or incorrect latch,” Jennifer shares. “Proper positioning, in most cases, can correct a poor latch and get a pain-free latch.”

You can also check (or ask a partner to observe) how your baby’s latch looks. Your nipple should look like it’s up against the roof of your baby’s mouth, with his or her tongue underneath. The top part of the dark skin around your nipple might be visible. However, your little one should have most of the lower portion of the dark skin around your nipple in his or her mouth. If it doesn’t appear like your baby is latching correctly and/or if breastfeeding still feels painful, don’t put off calling a lactation consultant. They’re trained to identify and address latching issues with a variety of strategies.

Pain during breastfeeding (or other any issue!) deserves reassurance

Getting some much-needed reassurance is an underrated reason to hire a lactation consultant, but it’s a valuable one—and it can make a really big difference in your breastfeeding experience. The reason is: new stressors are abundant in your first few months of parenthood. When you’re stressed, your body releases stress hormones like cortisol. These hormones significantly lower milk supply.

If any part of your new-parent stress stems from breastfeeding, working with a lactation consultant can alleviate your worries. With a little professional comfort and guidance, letting go of that stress is possible and breastfeeding can become a rewarding experience.

Should I hire a lactation consultant right away or wait to see if I have pain during breastfeeding?

Because life with a new baby or babies can be so busy, it’s a great idea to start thinking about lactation consultants before you go into labor. That way, if questions or pain during breastfeeding crops up, you already have a resource to help ASAP. While you’re pregnant, get recommendations from friends or acquaintances. You can also search for IBCLC consultants in your area using the “find” feature on the International Lactation Consultant Association’s website.

Considering a lactation consultant and have a few questions or want more info? Jennifer answers frequently asked questions she gets from the families she helps as a lactation consultant and talks about when you need to hire a consultant.

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