You’ve likely spent at least some time during your pregnancy worrying about the pain of childbirth.
But… what about breastfeeding pain? Once your little one arrives, there’s a good chance this will be a more pressing concern.
The reality is that many breastfeeding parents experience pain or discomfort at some point during their breastfeeding journey. While it might not be completely unavoidable, breastfeeding pain can be treated once you pinpoint the cause.
Read on for common causes for pain during breastfeeding, plus how to get some relief.
While we all hope to experience pure breastfeeding bliss from the very first feed, there are some discomforts that appear as you’re adjusting to this new skill. Luckily, most of these issues can be addressed to alleviate — or eliminate — the pain.
Many of the common causes for pain will come into play in the first days and weeks of breastfeeding. Others may not appear until you’ve been feeding for months.
Just like all things parenting, just when you think you’ve mastered something, a new challenge arrives.
It’s important to remember that each person is unique. The circumstances of your health history, the timing of your pain, and the symptoms you’re experiencing are best evaluated by a specialist, like an International Board Certified lactation consultant (IBCLC), who can specifically address your situation.
Ongoing breastfeeding pain can cause some serious psychological stress and shouldn’t be ignored.
If you’re curious where to start, consider the following questions:
Nipple pain is a common complaint during the early breastfeeding days. Some discomfort is possible as you work on perfecting your baby’s latch, but ongoing pain or skin damage is a sign that something needs to change.
Your nipples should look the same before and after a feeding. If your nipples appear flattened, pinched, or drained of color after a feed, it’s a sign that there’s a problem with your baby’s latch.
Latch issues can also cause skin damage, like cracking, bruising, or bleeding.
Tips for a good latch
- Make sure your baby is well supported. Use pillows to help raise your baby to the same level as your breast.
- Hold your baby facing the breast. In most positions, you and baby should be belly to belly. They shouldn’t have to turn their head to the side in order to latch.
- Compress your breast with your free hand in a C shape to help your baby take more breast tissue into their mouth. Hold your breast at the same orientation as your baby’s mouth, like you’re going to feed them a sandwich. Your nipple should be aimed toward their nose, not their mouth.
- Use your hand to support their head and bring them to the breast chin-first. Baby’s head should be tipped back, with their chin away from their chest. Try to hold baby at the base of the skull or the top of the neck. It will be tempting to push on the back of your baby’s head, but avoid doing this because your baby will reflexively pull their head away from your breast in response.
- Aim your nipple upward, toward the roof of your baby’s mouth. When they latch, their chin should be pressed close to the breast, their lips should flare out, and their nose should be free.
- Try different holds. The right angle and position can help to get a deeper, more comfortable latch. For example, laid-back positions can allow for easier positioning and better control of the latch.
If you’re concerned about your latch, ask your hospital or provider about resources. Lactation consultants, breastfeeding classes, and support groups may be available at little or no cost.
If you continue to experience latch issues, you may also want to evaluate whether your baby has a tongue-tie or other issue that may be affecting the latch.
If your nipples are damaged, it’s important to take steps to heal them. A few things may help:
- Gently rinse them after feeds to remove saliva.
- Let them air dry after feedings.
- Apply a lanolin cream, herbal salve, or pumped breast milk to the area. (Be aware that lanolin can cause a mild allergic reaction in some people.)
- Use cool packs, hydrogel pads, or pain relievers between feeds.
- Hand expression or a breast pump may allow you to pump milk until your nipples are healed.
- Nipple shields can give your nipples a break, but are best used under the guidance of a lactation specialist.
Another issue that can cause nipple pain is thrush. If you’re experiencing thrush, your nipples may appear flaky, shiny, or red. Thrush may also cause pain deep in the breast, either during or between feedings.
If you have thrush, it’s likely your baby does as well. Their symptoms may appear as white marks on their tongue and the inside of their cheeks, and red or cracked lips.
It’s also possible that they may not exhibit symptoms. Know that it’s normal for breastfed babies to have a thin white coating on their tongues.
If you suspect thrush, it’s important to talk to your provider. Often, the symptoms commonly associated with thrush are actually caused by a bacterial overgrowth. Your lactation consultant or provider can help evaluate your symptoms and may suggest oral or topical medications to treat it.
It takes a few days after birth for your body to increase milk production. When it does kick in, the increased blood flow and influx of milk may cause swelling that makes your breasts feel large, heavy, and hard.
Engorgement may reoccur during your breastfeeding journey if you miss feeds or struggle with an oversupply.
While engorgement is temporary and usually lasts only a day or two, it can cause some serious pain during that time. You may feel tender and sensitive throughout your breast, chest, and armpit area. Even sleeping or wearing clothing can aggravate your discomfort.
To alleviate engorgement pain, try:
- warm showers or compresses
- using hand expression or a pump to alleviate pressure between feeds
- using pain medications safe for breastfeeding
Have you ever been drinking a cookies and cream milkshake and gotten a clog in the straw? Suddenly even with suction you’re no longer able to drink your milkshake. You might need to squeeze the straw to release the plug.
Well… sometimes something similar can happen inside your breasts. For one reason or another, the milk may not empty from a duct, causing a clog to form.
Symptoms of a clogged duct include:
- a lump that may or may not be painful in one area of your breast
- a white mark or plug on your nipple
- discomfort in the breast during pumping or breastfeeding
Clogged ducts can happen for many reasons. Possible causes include:
- latch issues
- wearing restrictive clothing, including tight bras or those with underwire
- skipped feedings
If you suspect a clogged duct, your best course of action is to continue to breastfeed. You may want to use a warm compress and breast massage before or during feeds.
You can also experiment with different holds to more fully drain the breast.
If your clogged duct isn’t cleared, it may cause an infection in your breast known as mastitis. Symptoms of mastitis include:
- redness in the affected breast area
- flu-like symptoms, like fatigue, chills, or body aches
Speak to your care provider if you’re experiencing symptoms of mastitis since you may need antibiotics to clear it up.
It’s also important to seek medical advice if you have a lump that won’t go away, as your doctor might want to do testing to rule out cancer.
Letdown is your body’s hormonal response to nerve signals that indicate it’s time for a feeding. It may also happen when you hear a baby cry or even think about breastfeeding.
Some people describe it as a tingling sensation (and some people don’t feel it at all), but others experience a shooting pain in their breasts.
This pain may happen only during the early days of breastfeeding, but some people experience painful letdown at all feeds. If you’re struggling with this, you might want to consider if there are other factors at play. Sometimes a forceful letdown or an illness like thrush or mastitis can be involved.
Warm showers or compresses, skin to skin cuddles, and relaxation techniques may help you adjust to and manage your discomfort during letdown.
It’s likely you’ve found yourself spending a lot of time holding and cuddling your little one, and why not? Take advantage of those moments while you can.
But with all that extra weight you’ve got in your arms (that keeps increasing each day) it’s important to be aware of whether breastfeeding is contributing to your back pain.
Consider your positioning for feeds. Make sure that you’re bringing the baby up to your breast, not hunching forward. Use pillows for additional support and find a comfortable space for feedings.
You might want to try laid back or side lying positions, as they’ll allow you to stretch out with your baby and alleviate pressure on your back.
And of course, make sure you’re staying hydrated and incorporating movement into your days.
While the breastfeeding journey may have some speed bumps along the way, breastfeeding pain generally has a cause — and a solution.
Finding the right fix can allow you to enjoy breastfeeding and focus on the wonderful ways you’re helping your little one grow.
If you find yourself dreading each feed, gritting your teeth during every latch, or otherwise suffering, it’s important to seek help from a lactation consultant or your midwife or doctor. They can help you figure out what type of feeding is right for you.