A painful breastfeeding experience is very stressful for a new mother and baby. The breast or nipple pain might be so intense that a mother begins to dread each and every nursing session.
This can potentially affect a mother’s breast milk supply.
The good news that with correct management, most women can overcome painful breastfeeding.
When breastfeeding hurts – 11 causes of painful breastfeeding
In most cases, the fastest way to pain-free breastfeeding is to figure out the cause of pain. The best way to do this is to work with someone who’s skilled in breastfeeding support.
This could be a lactation consultant (IBCLC) or a breastfeeding counsellor (e.g. from the Australian Breastfeeding Association or La Leche League).
It might also be helpful to have some idea of what you might be dealing with.
Here are 11 causes of painful breastfeeding:
#1. Poor positioning at breast (nipple pain)
A baby who isn’t positioned and attached properly might have a shallow latch at the breast, which can cause anything from mild to intense nipple pain.
If babies have a poor latch, it can also affect their ability to transfer breast milk effectively while feeding. Reduced milk flow increases the risk of engorgement, a clogged milk duct and mastitis – all of which can cause breast pain.
Learning to position your baby correctly can take some time.
You can read some helpful tips in BellyBelly’s article Learning to Latch: A Key To Breastfeeding Success.
#2. Nipple damage (sore nipples)
Poor positioning and attachment are the main causes of nipple pain and damage.
Many new mothers experience cracked nipples because their baby has a shallow latch. This means the nipple isn’t being stretched to the back of the mouth. Instead it’s crushed against gums or hard palate.
Although nipple shields might offer temporary relief, effective treatment begins with correcting your baby’s positioning when breastfeeding. This will then improve the baby’s attachment and result in a deeper latch. It will also help your baby to get more milk at each feed.
#3. Oral ties or palatal anomaly
Occasionally, even with good positioning at the breast, nipple damage can occur, especially if baby has a tethered oral tissue or ‘tongue tie’.
If tongue movement is restricted because of a tie, then a baby cannot achieve a deep attachment on the breast or transfer milk effectively.
A palatal anomaly is often associated with oral ties. A short or tight frenulum causes the tongue to lie against the floor of the mouth rather than resting against the roof of the mouth, resulting in a high arched or narrow palate.
For more information about tongue tie, you can read BellyBelly’s article What is Tongue Tie? – 8 Facts To Be Aware Of.
#4. Engorgement (breast pain)
Typically, between days 2 and 5 after the birth of your baby, you will notice your milk ‘coming in’.
You can read more about this process in BellyBelly’s article When Does Breastmilk Come In? | 7 Important Facts.
If your baby isn’t properly latched or isn’t feeding effectively or frequently enough, then you can experience engorgement.
Engorgement is a more severe form of normal breast fullness. Your breasts become very full, hard and sore, and it might be difficult to attach your baby deeply to the breast. It is common in the first few weeks after birth.
For advice about managing breast engorgement, you can read BellyBelly’s article Engorgement – Relief For Breast Engorgement.
#5. Vasospasm (nipple pain)
When your baby comes off the breast, does the nipple look white and do you feel a burning pain? Do your nipples go white when exposed to cold and cause a burning pain?
If so, you might be experiencing a condition called nipple vasospasm. Vasospasm occurs when blood vessels tighten, resulting in impaired blood flow to extremities of the body.
You can learn more about treating vasospasm in BellyBelly’s article Vasospasm | Symptoms And Treatments For Vasospasm.
#6. White spot (nipple pain)
Do you have a pinhead sized spot that looks like a milk-filled blister on the tip of your nipple?
This might be a white spot. A white spot is also commonly referred to as a blocked nipple pore, a bleb or a milk blister. If the spot is painless you don’t need treatment, as it will usually resolve on its own.
However, if the white spot is causing pain, try soaking your nipple in warm water for about 5 minutes, before you start breastfeeding, then gently rub it for a minute with a clean, soft towel.
If it doesn’t go away, seek guidance from your healthcare provider.
#7. Blocked duct (breast pain)
If you have a small, painful lump in your breast, it could be a blocked milk duct. To treat it you can:
- Apply warmth to the affected area for a few minutes before feeding
- Breastfeed as normal
- Apply cold to the affected breast after feeding
- Ensure you are wearing a well-fitted, wire-free nursing bra.
You can read more about treating blocked ducts in BellyBelly’s article Blocked Milk Duct – Symptoms And Treatments.
#8. Mastitis (breast and nipple pain)
If you suddenly feel like you have the flu, and have a warm, red, tender spot on your breast, you might have mastitis.
Mastitis is an inflammation of the breast, often caused by blocked milk ducts. In some cases (but not all), it can lead to a breast infection.
The most effective treatment for mastitis is to continue breastfeeding or to express milk as often as you would usually do. Using warm compresses before a feed can help with milk flow; cold packs after a feed can help reduce inflammation.
You can read more about treating mastitis in BellyBelly’s article Mastitis | Breastfeeding, Symptoms And Treatment.
It’s important to see a doctor if you think you have mastitis because, if it develops into a breast infection, it will need to be treated with antibiotics.
#9. Thrush infection (breast and/or nipple pain)
Do you have sharp, stabbing nipple pain after feeds, and shooting pains that go into your breast? If so, you might be experiencing nipple thrush. Nipple thrush is a yeast infection caused by an overgrowth of Candida albicans. Candida albicans thrives in warm, moist environments, so changing breast pads regularly is important.
Because nipple damage or a bacterial infection can have symptoms similar to nipple thrush, it’s important to seek help from a healthcare professional, to work out what might be going on. Thrush infections are often over diagnosed in breastfeeding mothers with nipple or breast pain.
For more information about nipple thrush, you can read BellyBelly’s article Breast & Nipple Thrush | 7 Signs Of Breast & Nipple Thrush.
#10. Incorrect flange sizes (breast pain)
If you are using a breast pump, it’s important to use the correctly sized breast flange. An incorrectly sized flange can increase the risk of damaged or sore nipples.
Using a vacuum setting that is too high can also increase the risk of nipple pain and damage. Remember, it’s not normal to feel pain while pumping milk. Also, pressing the breast flange too firmly into your breast can cause breast pain and increase the risk of blocked ducts.
Using the incorrect flange size can also result in yielding less breast milk each time you pump, potentially affecting your milk supply.
A lactation consultant will measure you to determine whether you’re using a breast flange of the correct size.
#11. Biting (sore nipples)
Just because your baby is getting teeth doesn’t automatically mean it’s time to wean.
The first teeth to erupt are typically the bottom front ones. When your baby feeds, this area is covered by your baby’s tongue.
However, some babies might bite before they’ve attached or when they’re coming off the breast. This can hurt.
For tips on managing your baby’s biting, you can read BellyBelly’s article Biting While Breastfeeding – 5 Tips To Stop It.
Painful breastfeeding is almost always treatable, so don’t be afraid to get help if breastfeeding hurts.
