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Does Breastfeeding Hurt? Dealing With Painful Breastfeeding

By Jennifer Lincoln, MD, IBCLC, Board Certified OB/GYN
We cover a lot about breastfeeding here, yet one of the biggest concerns new moms often have is worrying if breastfeeding will hurt. They’ve been told horror stories of toe-curling feeds, bleeding nipples, and babies who bite. Here’s what you need to know about nursing and managing any pain that may come with it, so you don’t let the pain get in the way of a happy breastfeeding relationship.

Should breastfeeding hurt at all?
We cover that question in more detail here, but basically some soreness is to be expected in the first few days. Pain worse than this is not OK.

What kind of pain is not normal?
Any kind of pain that lasts the entire feed or is excruciating for you is not normal. Also, while it is normal to be a little sore for the first week, if this continues, you need to get checked out to see what’s going on. Lastly, any pain that is related to nipple trauma (think cracked, bleeding nipples) is not OK and is a sign you need help, and quickly!

What might cause pain with breastfeeding?
A few things can be the culprit, but it often boils down to a shallow latch. Breastfeeding only works when your baby has a good deep latch and has not only the nipple but also some or all of the areola in his mouth. A latch that is too shallow means your baby is chomping down on your nipple which causes — you guessed it — pain. A shallow latch can happen because of flat or inverted nipples, a tongue-tie in your baby, or because a baby has a small mouth, recessed chin, or different shaped arch of the palate. It can also be because the positioning at the time of breastfeeding isn’t quite right.

Breastfeeding pain can also be caused by other conditions, such as a nipple or breast infection (think yeast as one reason) or because of a condition known as vasospasm.

Do I just have to put up with it?
No! While that soreness we mentioned in the early days usually just needs to run its course, you can get some comfort by using cooled gel pads on the nipples as well as nipple cream. Any of the other kinds of pain we mentioned should be evaluated and treated, and the sooner the better so your nipples don’t get too damaged, you don’t get a breast infection from open cuts on the nipple, and your milk supply doesn’t suffer. You don’t want to let this pain be the reason you throw in the towel, so reach out for help right away.

You should seek medical advice to solve this problem.
First, all the details about your pain and how breastfeeding has gone so far will be taken. Ideally, you and your baby will be examined (especially checking his mouth and tongue function). His weight would be checked and a feed might be observed. Depending on what seems to be the problem,a tongue tie release, working on different nursing positions to get a better latch, prescribing a medicated cream to treat the nipples, or using a nipple shield, among other things might be recommended. 

It’s important during this emotional time that you get the rest and support you need so you don’t lose sight of enjoying your baby in these early days. It will get better, but only with the right help and support!

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