Experienced mothers and doctors may say that breastfeeding should not be painless exercise. In theory they are right!
It is not supposed to be a painful process after you make it through the first few days, and your body adapts.
In reality, there are a number of complications that can cause pain while you are breastfeeding. This post will help you identify what kind of pain is considered normal, and what may require medical intervention.
Most importantly, what you can do to relieve any pain you are experiencing.
Is Pain while Breastfeeding Normal?
There are several possible causes of breastfeeding pain. It is important to know the difference between the type of pain that is considered normal, and what may require specialized attention.
You can expect to experience aches and pains associated with breastfeeding during the first few days, to weeks after birth. Depending on how quickly your body adapts to these new demands.
These may include:
- Cramping – your uterus is shrinking
- Initial discomfort with latching – your breasts aren’t used to the wear and tear
- Slight burning or tingling – your milk is letting down
- Pressure from engorgement – your breasts need to regulate milk supply
All of these symptoms should subside after a short period of time as your body gets used to what’s required for breastfeeding your little one.
Over time, your body will adjust as follows:
- Regulate your milk supply to prevent engorgement
- Your uterus will be done shrinking
- Your nipples will toughen up
- And you won’t even notice your milk letting down anymore.
Once you get past the initial aches and pains breastfeeding should be virtually pain-free.
However, there are still some pains that you may experience that aren’t necessarily normal.
- Nipple pain that doesn’t go away
- Cracked or bleeding nipples
- Tender lumps in the breast
- Fever and flu-like symptoms associated with a red lump
If you notice any of these things, you should consult your doctor for further instructions and possible treatment.
Causes of Pain while Breastfeeding
Let’s elaborate a bit more on the abnormal pains you may experience with breastfeeding:
The first few days of breastfeeding can be very difficult. Your sensitive breast skin isn’t used to the strength of a baby’s suction when breastfeeding.
Your skin will stretch and swell, possibly even becoming chapped and cracked.
You aren’t alone in this; nearly 90% of women claim to have nipple pain in the early days of breastfeeding.
Most say that the pain peaks around day 5 after birth then starts to get better. The question is how to push through until then.
The most important thing to remember is not to give up on breastfeeding.
It can be very tempting to throw in the towel and call it quits, but if you can make it through this first phase, you will be fine until your baby is ready to wean.
At the start of a breastfeeding session, try latching your baby onto the least painful nipple before switching to the other side.
By the time they are ready for the second breast, their hunger has already been somewhat satisfied and they shouldn’t suck as hard.
Between feedings, take care of your nipples.
Lanolin cream or just a bit of breast milk massaged onto the nipples can give you some relief.
Just be sure to let them air dry completely before putting your bra or breast pad back on to prevent unwanted yeast growth.
If you find that you are still experiencing nipple pain and chafing after the first week or two of breastfeeding, you may want to take a look at your baby’s latch.
Remember, some tenderness and soreness is normal, but blisters and cracked skin are not.
Your baby may not be born with teeth, but that doesn’t mean their little mouths can’t hurt you if they aren’t latched properly.
Due to the tough ridges and bone under the gums, you will know immediately if your baby’s latch is wrong.
With a proper latch, you should be able to see any of your nipple and just a small portion of your areola should be visible.
This puts your nipple as the back of your baby’s mouth where their soft palate is, reducing the amount of pressure that is directly on your nipple.
You also need to make sure your baby is centred over the nipple when latching. If they are latched on slightly crooked, they may be taking in more breast tissue than nipple, reducing milk flow and possibly creating blisters.
If you are having trouble getting your baby to latch correctly, schedule an appointment with a lactation consultant. They will be able to show you the proper technique to get your baby to latch perfectly every time.
Blocked milk ducts can be a pretty common occurrence when breastfeeding but they are also preventable for the most part.
When your milk isn’t flowing properly or your breast is not drained efficiently, milk can become trapped in a duct, blocking off your milk flow and causing pain.
You may notice that the painful area is also swollen and red.
Blocked ducts can be the result of poor breastfeeding habits – poor latch, inefficient breast draining, engorgement – or they can be the result of a personal habit or lifestyle such as fatigue, dehydration, or a poorly fitted bra (too much pressure).
Most treatments can be done at home and very rarely require medical attention. Warm compresses on the affected area can help with your let-down reflex to get the milk flowing easier.
Massage and hand expression (or breast pumping) can also help relieve the obstruction.If you are having trouble with your baby’s latch, don’t hesitate to visit a lactation consultant.
They can help to reposition your baby and show you what a proper latch looks and feels like so you can prevent future blockages.
While not restricted to breastfeeding mothers, mastitis is an infection that can occur as the result of improper or difficult breastfeeding.
It often starts as a blocked duct, which is uncomfortable but easily fixed. However, when the duct isn’t cleared, the milk inside can become infected with bacteria.
Symptoms of mastitis can mirror those of a blocked duct but they are usually much more severe. You may notice a red or swollen area of your breast that is hot to the touch or a hard lump where the duct is blocked.
In addition, you may also feel a burning sensation that is continuous or may only be noticed when you are breastfeeding.
Flu-like symptoms such as fever, chills, and aches are also common.
Mastitis can be treated with many of the same home treatments you would use for a blocked duct. It may seem like the last thing you want to do but you should focus on continuing to breastfeed your child. Maintaining milk flow is the best way to clear the duct.
In more severe or persistent cases of mastitis, you may need to visit your doctor. They may choose to prescribe an antibiotic to help clear the stubborn infection.
Once breastfeeding has been established, you shouldn’t feel any pain. In fact, most mothers don’t really notice any particular sensations when their milk lets down or when their baby latches on.
However, some women say they can always feel when their milk lets down, using it as an alarm clock for their baby’s next feeding.
They may just be more sensitive or they may have a strong let-down reflex.
A strong let-down may not be as painful as a blocked duct or engorgement but it can be uncomfortable. Many women describe their milk let-down feeling like a tingling or burning sensation.
Sometimes the feeling is enough to make you squirm a little.
There isn’t much you can do to prevent this uncomfortable feeling. However, when you do notice your milk letting down, you should be prepared to pump or breastfeed soon so that you don’t end up with a painful blocked duct or a case of engorgement.
If you are breastfeeding or pumping your milk on demand you should not experience engorgement, but every mother knows that it doesn’t always happen like that.
You may not be in a place that you can empty your breasts right away, finding yourself uncomfortable and in a bit of pain by the time you are able to find a place to relieve the pressure.
Breastfeeding is the simple cure for this discomfort, but if you need a bit of relief before you’re able to sit down to feed or pump, you can hand express a little milk to release a bit of pressure.
Don’t ignore this discomfort for too long though. Prolonged engorgement can lead to more pain with blocked ducts and potential mastitis.
There are very few things that cause pain while breastfeeding that can also affect your baby. However, thrush is one of those things.
Oral thrush is a common yeast infection in babies. It is usually the result of an overgrowth of candida yeast, the same yeast that is responsible for vaginal yeast infections and some diaper rashes.
It can often be painful for babies to breastfeed with thrush since the skin on the lips, tongue, or inside the cheeks may be cracked or irritated.
The biggest problem with thrush is that it can be passed back and forth between mother and baby. You may notice that the same sort of rash that appears around or in your baby’s mouth is present around your nipples as well.
Thrush on nipples may feel like burning or itching, or you may notice a sharp stabbing pain as well as slight nipple discoloration, swelling, or inflammation, and irritated, cracked skin.
Needless to say, breastfeeding with thrush can be very painful for mother and baby.
If you notice any of these symptoms on you or your baby, you should see your doctor.
Chances are that you have both already been exposed and need to be treated with medication. Yeast can be very difficult to get rid of once it’s present since it spreads so quickly.
You can also pay close attention to your habits at home to prevent future breakouts. Always wash your hands and breasts before and after you breastfeed. Change your breast pads regularly and keep the area dry between feedings.
You should also clean any of your baby’s items, especially the ones that go in their mouth if there has been a recent outbreak of thrush.
A small defect in your baby’s oral anatomy may also be the cause of painful breastfeeding.
Tongue ties – when the cord that stretches from the underside of the tongue to the floor of the mouth is shortened – aren’t extremely common, but they are something to be aware of when you are breastfeeding.
Because of the way a baby’s mouth should be shaped while breastfeeding, limited tongue mobility can drastically affect the way your baby latches and the way your milk flows.
Blocked ducts and mastitis can also be effects of a tongue tied baby.
Many years ago, most doctors and parents would choose to have the tongue ties cut to free up movement, but recently a concern has risen due to many wanting to avoid putting a baby under anesthesia for an unnecessary surgery.
Instead, doctors and lactation consultants will now work with mothers and their babies, teaching them to work around it rather than resorting to surgery.
Your lactation consultant can help to correct poor sucking so that your baby and your breasts don’t suffer.
If you notice pain and discomfort while breastfeeding coupled with blanching of the nipple, you – and possibly even your doctor – may just assume that you have thrush.
However, these symptoms can also be the result of Raynaud’s disease.
Raynaud’s can affect anyone, though it is rare, and it isn’t limited to the nipples. This condition causes abnormal spasms in arteries, which cause the restriction of blood flow resulting in numbness and pain.
This phenomenon typically affects the extremities, including the fingers, toes, earlobes, and nipples, and is usually triggered by extreme temperatures or stress. Needless to say, breastfeeding can cause a lot of pain in a mother with Raynaud's.
The key to reducing pain due to Raynaud’s is to avoid anything that can restrict blood flow.
This includes alcohol, smoking, coffee, certain medications, and dehydration.
In some cases, your doctor may prescribe high blood pressure medication, which has been found to treat Raynaud’s symptoms.
Tips to Minimize Pain
With all the possible causes of pain while breastfeeding, it can be difficult to narrow down what your particular symptoms are and know how to treat them.
As a general rule, follow these tips to help minimize most breast pain:
- Make sure your baby is latched properly every time.
- Ask your doctor for a cream or ointment recommendation for sore, cracked nipples.
- Massage some breast milk on your nipples at the end of each feeding and allow the area to dry completely before putting your bra or breast pad back into place.
- Consider breast shields, which are worn between feedings in order to create a barrier between your sore nipples and your clothing.
- Try using nipple shields while feeding – only with the approval of your doctor or lactation consultant since the use of nipples shields can interfere with milk production.
- Breastfeed more frequently for shorter periods of time rather than extended feedings.•Nurse on the less sore side first.
- Gently break your baby’s suction by sliding your finger between your baby’s lips and your breast.
- Apply a warm compress to your breast right before feeding to help your milk let down.
- Apply a cold compress to engorged breasts after feedings to relieve soreness.
If you find that these things are not helping, see your doctor or lactation consultant to rule out other possible causes that cannot be treated at home.
Most importantly, don’t give up on breastfeeding. Don’t let the pain beat you. Rather treat the cause and eventually, you will find that it gets easier.
Is it normal to cramp while breastfeeding?
Some cramping and uterine spasms are normal during the first few weeks after birth, especially when breastfeeding.
Nipple stimulation during feedings releases oxytocin, the hormone responsible for milk let down. This hormone makes your uterus contract, helping it shrink back to its pre-pregnancy size.
These cramps shouldn’t cause significant pain, but they may be uncomfortable.
Mothers who have undergone a C-section may experience more discomfort than those who had a vaginal birth. If the pain becomes severe, reach out to your doctor.
Can I take pain relievers while breastfeeding?
It’s important to keep in mind that anything you ingest can be passed to your baby through breast milk.
However, the amount of medication passed to your baby from OTC pain relievers is very low, posing very little risk to your baby.
Be sure to follow the dosage instructions very closely, sticking to simple acetaminophen and ibuprofen.
Avoid opioid medications such as those with codeine. These can cause your baby to become very sleepy and potentially cause breathing problems or body limpness.
Can I still breastfeed with an infection?
With infections like mastitis, it is perfectly safe to breastfeed your baby though it may be very painful until it is cleared up.
It is actually encouraged in order to help break up the milk that is blocking the duct.
It is also generally safe to breastfeed even if you are taking antibiotics for the infection. Just be sure to speak with your doctor if you have any questions.
Is engorgement normal?
Engorgement can happen to anyone, but it is not necessarily a “normal” thing.
Keeping to a pumping schedule or breastfeeding on demand is important to keep your supply in check and prevent engorgement.
Prolonged engorgement can be extremely painful and can even lead to blocked ducts and mastitis.
Should I exercise if I’m experiencing breast pain?
Exercise is safe once your body heals after birth and you get clearance from your doctor, and while you may be anxious to get back to it, you want to be careful.
You may feel that a tight sports bra is the only way to exercise comfortably, especially if you are doing a lot of cardio or you are experiencing breast pain, but you should try to avoid wearing them for longer than the duration of your workout.
Tight sports bras can cause more harm than good when it comes to breast comfort and milk production. They put you at a higher risk for blocked ducts and mastitis. Choose support over tightness.
Once your doctor gives you the go-ahead to start exercising again, take it slow to avoid causing more breast pain. Wear nursing pads to prevent leaks while working out.
In addition, if you are prone to mastitis, take it easy with the upper body weight workouts.
Other than these things, only workout at a level that is comfortable for you. If you are experiencing pain, opt for something lower impact.
I sleep on my stomach. Will that cause me pain?
If you are a stomach sleeper, pregnancy was likely torture for you. You were probably counting down the days until that belly was gone and you could finally roll over again.
However, you may not have realized that breastfeeding can also cause issues when sleeping on your stomach.
There is a chance that your milk supply will slightly decrease during the night by sleeping on your stomach due to the pressure on your breasts, but this isn’t a huge cause for concern since your body will make up for it during the day.
The biggest problem with sleeping on your stomach while breastfeeding is the likelihood that you will experience leakage and some discomfort.
If you are already experiencing breast pain from breastfeeding, sleeping on your stomach may exasperate it.
Pay attention to your body’s signals and only do what is comfortable for you.
Though breastfeeding is supposedly pain-free, there are many potential causes of pain associated with it. We have not even covered the inevitability of being bitten at some stage!
Unless you latch your baby perfectly and completely drain the breast every time, you will likely experience some sort of pain at some point before your baby is weaned.
If you do experience pain, take care of your body and work with your doctor and/or lactation consultant to pinpoint the cause of pain and find proper treatment.