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Early Days
Pain in Breastfeeding
pain (noun) Highly unpleasant physical sensation caused by illness or injury.
Whilst many mothers experience pain at some point during breastfeeding, pain when breastfeeding should never be considered normal. Pain is not a stage or phase that you have to “work through” to get to comfortable breastfeeding. Pain, either in the nipple or breast, is almost always a sign that something is wrong.
It is worth mentioning that in the very early days you may experience a few seconds of intense discomfort at the beginning of the feed as your baby takes their first few vigorous sucks. This sensation should not continue as the feed progresses.
Most commonly the reason for painful breastfeeding is that your baby is not attached effectively at the breast. As well as being painful for you, your baby won’t be getting as much milk as they would if they are comfortably and well attached. A further cause of breastfeeding pain could be an infection.
Jenny Hemsley, NCT Breastfeeding Counsellor, looks at causes of breastfeeding pain.
Indicators of poor attachment at the breast:
- Your baby comes on and off the breast during a feed.
- Your baby’s suck is shallow and uneven rather than deep and rhythmic.
- Your baby swallows infrequently.
- Your baby doesn’t take herself off the breast, or she falls off and wants to feed almost immediately.
- Your nipple or nipples are misshapen (either pinched, lipstick shaped, blanched of colour) after feed – they should look how they did before they went into your baby’s mouth.
- Your nipples hurt throughout the feed and/or are cracked and bleeding.
- Your breasts are sore, painful, lumpy or inflamed.
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What might the pain feel like and what can you do?
Nipple pain at start or during the feed - check the position of your baby at the breast - are they being held close enough with head and body in line (“tummy to mummy”) and/or opening their mouth wide enough (starting “nose to nipple”) and taking enough of the breast, areola and nipple into their mouth so that their chin ends up pressed against your breast. Nipple pain can also be caused if your baby’s tongue is short and does not extend enough to grasp the breast well and/or your baby has a tongue tie whereby the tongue cannot extend properly. If you suspect this could be the cause of the problem, ask for a tongue function assessment.
Breasts feel hard to touch, may be red and swollen and swelling extends to armpits (aka “engorgement”) - check attachment and feed as often as your baby wants for as long as they want. If your baby isn’t feeding effectively, use gentle massage and express some milk to make your breasts comfortable.
Pain in one breast especially during feed - breast may feel tender and there may be a small hard lump in the breast or white spot on nipple (indicative of “a blocked duct”). Check attachment, gentle massage over lump towards the nipple, feed your baby or express.
Sharp or burning breast pain in both breasts during and after feed - check for thrush infection with GP. Infection requires treatment for both mum and baby.