What can cause breastfeeding pain and how can you resolve it?
Many breastfeeding parents can experience pain, especially in the early days – but what causes this pain, and how can it be remedied?
Breastfeeding a newborn is a brand new experience for parents as well as babies, and just like learning any new skill, it takes patience and practice.
Choosing whether to breastfeed is a personal decision, and no parent should feel pressured or judged about how they feed their baby. However, for those who do choose to breastfeed, it can be common to experience a painful latch, explains Maxine Palmer, head of parent services strategy and innovation at the National Childbirth Trust (NCT).
“There are many different factors after birth that can affect breastfeeding, everyone has their own unique anatomy, pregnancy and birth experience,” Palmer says.
“For example, if the baby has been in a very tight position, they can take a while to release after birth and for their jaw to move nice and easily.”
“And while it’s normal for everyone to experience some nipple pain, if it’s persistent and a mother is experiencing it over a couple of feeds, then getting breastfeeding support early on can make a really big difference.”
Resolving latch and attachment
“The most common reason for nipple pain is a poor latch, which causes the baby to suck only on the nipple,” says Palmer.
“Essentially, pain is caused by friction on the nipple, which won’t happen if you’ve got a nice deep latch.”
Poor latch can be caused by a combination of things, such as the position of the baby and the attachment of the baby’s mouth around the breast.
“It’s about having enough nipple in the baby’s mouth so that, ideally, the nipple is positioned high up in the baby’s soft palette,” says Palmer.
“The nipple isn’t moving once the baby’s latched on and sucking to make a vacuum.
“That sucking and the waves that the tongue are making should be far back away from the nipple on the areola and more of the breast tissue.”
Moving into the right position
Whether breastfeeding parents find side lying, a cradle hold or laid-back position the most comfortable, what they’re trying to stimulate in the baby is a wide-open mouth.
“For some, that might be by having the baby in close contact which can help them spot early signs of the baby wanting to feed,” Palmer says.
“Aim to get the baby’s nose towards your nipples, because sometimes reaching the baby too far over means that they haven’t got the nipple centralised in their mouth.
“Make sure the baby’s body is in alignment, so the head, neck, spine are all in a nice line and the baby isn’t twisted. If side feeding, it’s also really important to roll the baby’s body in towards you, so their tummy, arms and legs are all in contact with your body.”
To help correctly position the baby on the breast, their chin should be pressed into the breast, while the nose is free for air circulation.
“The baby’s head should be free to tilt back so they can deepen the latch,” Palmer adds. “Often that small adjustment can reduce pain on the nipple.”
Swollen breasts
“Breastfeeding can be fairly straightforward for some women in the early days, but then as the breasts start to change from producing colostrum to producing mature milk, they can become very full and engorged,” says Palmer.
“It helps to express a bit of milk using a hand pump to soften the breast and make it easier to latch.”
Tingling sensation
“Let-down is a strong tingling in the nipples, and that’s a big release of hormones and blood flow and the milk releasing,” explains Palmer.
“Sometimes having warm nipples can help the pain, and sometimes expressing milk before starting. If it is let-down, generally for most women, it passes after a couple of minutes.”
Mechanical issues
“After feeding your baby, see if your nipple came out the same shape as when it went in,” she advises.
“If it’s different, the latch could either be improved, or there might be something mechanical, like tongue tie.
“If your nipple has got little white, red or blue marks after feeding, that means it might have been very compressed, which is called vasospasm and can be very painful. Heat treatment and improving the latch can help.”
Painful infections
“Mastitis is an infection caused by milk leaking into the breast tissue,” explains Palmer. “You’d see red marks on the breast, and the breasts would be hot and sore to touch.
“Really frequent feeding and heat treatment is needed, because what you’re trying to do is get the milk flowing really well.”
Over-the-counter painkillers and cooling gel packs will help, but if symptoms persist, contact a doctor.
“Finding a little pea-size lump could be a blocked duct. It can help to feed your baby from that point,” she advises.
“For example, if the lump was at the top of your breast, you could lie flat on your back with a baby coming over your shoulder and latching like that.”
If a parent has a period of pain-free breastfeeding and then suddenly notices a burning sensation and her nipples are red and shiny, it could be thrush.
“If there are white dots inside the baby’s mouth which can’t be wiped away, they can be treated with antifungal gel for the baby, and a topical nipple cream for the mother.”
NCT is the UK charity for pregnancy, birth and early parenthood. Find out more at nct.org.uk.