Yikes! Who knew breastfeeding could be so painful? The truth is that there can be a lot of pain associated with breastfeeding, especially in the early days. Here, we’ll talk about what might bring on breastfeeding pain and what to do to fix it. For any of these issues, check in with your care provider about over the counter medications, such as ibuprofen and acetaminophen, and strategies like ice or heat that might provide temporary relief of pain.
The single most common cause of breastfeeding pain in the early days is that your baby has a not-great latch. The latch is the way they attach their mouth to your breast during breastfeeding. If it’s not quite right, it can be excruciating during breastfeeding and even lead to abrasions and nipple cracking, which open the door for serious issues like mastitis, which is an infection of the breast that can lead to more pain.
In general, a good latch means that baby is taking into their mouth enough of your breast that your nipple does not rub against their hard palate (the bony part of the top of the mouth—you can probably feel this in your own mouth if you reach up with your tongue), but instead extends to the soft palate, which is much easier on the delicate tissue of your nipple. The trouble is, babies have small mouths, and they’re often used to being squished a certain way from being in the womb for the preceding nine months, which can mean they prefer to turn their heads a certain way or that their jaws are less mobile.
Things that can help address problems with a painful latch are:
- Getting support from a peer or a professional: sometimes all you need is for someone who knows to show or tell you how to get your baby to latch correctly. This might be a peer or it might be a lactation counselor or lactation consultant, but anyone who can help you latch your baby so that nursing is not painful is a great resource.
- Baby getting older: as baby grows, their mouth will get bigger, allowing them to get a fuller latch, and they’ll loosen up and let go of some of the squished up habits they developed in the womb.
- Pumping: if your nipple or breast has been damaged to the point of cracking, which might also involve bleeding, it’s okay to give that breast a break for a few feeds or a few days. If you use your pump to replace any feeds that you would have done with that breast, you’re less likely to affect your milk supply.
Engorgement is when your breasts swell with fluid, both milk and lymph—a clear liquid that helps the body regulate itself. It usually happens when your baby is young and your milk is just coming in. Engorgement can be so painful as your breasts swell and maybe feel hard like rocks and your skin stretches. Breast massage can be particularly helpful for engorgement (there is a great instructional video by Maya Bolman easily accessed by an internet search). One thing that might not be helpful is pumping, as that level of milk removal from your breasts will likely just signal them to make more milk—the last thing you need.
As discussed above, mastitis is a bacterial infection of the breast. If you have mastitis, you’ll likely feel fine, then you might have some breast pain that could be localized to one spot on the breast or might feel just like a diffuse ache—this is usually the sign of a clogged duct, one of the precursors to mastitis. If your clogged duct progresses to full blown mastitis, you’ll likely feel terrible all of a sudden and have a fever. The best thing to do in this case is to call your care provider immediately (if there is an on-call doctor or midwife, call that person) because mastitis is a serious infection that can quickly get out of control and often requires treatment with antibiotics. Sometimes, you can treat a clog before it progresses to mastitis by drinking lots of fluids, gently massaging or using vibration on the breast, and nursing your baby a lot on that side, especially if you can get their chin positioned roughly over the sore area, which can help tease out the clog.
If you’re breastfeeding when your period comes back or breastfeeding and get pregnant again, nursing can suddenly become much more painful. If your pain is related to your monthly cycle, you can alleviate some of it by being well-hydrated and well-rested in the days leading up to both ovulation and menstruation. Taking calcium and magnesium supplements in dosages recommended by your care provider might also help.
Nursing while you’re pregnant can be more intense, both because of the pregnancy-related hormones and because of the strong emotions of nursing one baby while you’re pregnant with another. Sometimes it might make sense to wean your nursling, but other times you might wish to continue nursing and maybe even tandem nurse. If the pain is beyond what you want to deal with or you start to feel resentful of nursing, it’s okay to wean your older child.