When Breastfeeding Hurts – 10 Causes of Painful Breastfeeding

When Breastfeeding Hurts – 10 Causes of Painful Breastfeeding

When everything is going well, breastfeeding can be a very rewarding and enjoyable time in a woman’s life.

When breastfeeding hurts, it can be very stressful.

Many mothers have found themselves dreading the next breastfeed because of pain.

The good news is most women can overcome painful breastfeeding and get back to enjoying the experience.

When Breastfeeding Hurts – 10 Causes of Painful Breastfeeding

The most important thing is to seek prompt help from a lactation consultant (IBCLC) or breastfeeding counsellor (e.g. from the Australian Breastfeeding Association or La Leche League) who can help you work out why breastfeeding is so painful.

It might also be helpful to have some idea of what you might be dealing with.

Here are 10 causes of painful breastfeeding:

#1: Suboptimal Positioning

A baby who isn’t positioned well at the breast might not be able to attach deeply enough; this will be more likely to hurt a mother’s nipples.

Suboptimal positioning at the breast can mean baby isn’t able to remove milk so well from his mother’s breasts; this increases the risk of engorgement, blocked ducts or mastitis (all of which can cause pain), and can also result in low milk supply.

Learning to position your baby optimally can take some time. You’ll find some helpful tips here.

#2: Engorgement

Typically, between days 2 and 5 after the birth of your baby, your milk ‘comes in’. As long as milk is removed often and well from your breasts, you’ll feel the normal breast fullness many mothers experience. This lasts for only a brief time and is not particularly painful.

However, if there are problems with how well your baby is positioned at your breast, and how well your baby is feeding, or if milk is not removed often enough, then you might experience engorgement. This is a more severe form of normal breast fullness.

When your breasts are engorged, they become very full, hard and sore. It is often more difficult for your baby to attach to your breasts.

Here are some tips about how to manage breast engorgement.

#3: Vasospasm

Look at your nipple when your baby comes off the breast. Does it look white? Can you feel a burning pain? Do your nipples feel sensitive to cold, and go white when exposed to cold (e.g. when you open the fridge) and cause a burning pain?

If so, you might be experiencing a condition called nipple vasospasm.

Learn more about treating vasospasm here.

#4: Nipple Damage

Suboptimal positioning and poor attachment are the main causes of nipple pain and damage. If this happens, treatment should start with correcting how your baby is positioned to breastfeed, which will then optimise the baby’s attachment.

There are various options available to help heal damaged nipples. A healthcare professional can help you work out what might work best for you. Occasionally, even when positioning at the breast is optimal, nipple damage might still occur – if, for example, a baby has a tongue tie.

#5: White Spot

Do you have a spot (about the size of a pinhead) which looks like a milk-filled blister on the tip of your nipple? If so, it might be a white spot. If it isn’t painful, no treatment is required and it will usually resolve on its own.

If the white spot is causing you pain, before feeds you could try soaking your nipple in warm water for about 5 minutes. Then gently rub it for a minute with a soft towel. If it doesn’t go away, seek guidance from your healthcare provider.

#6: Blocked Duct

If you have a small, painful lump in your breast, it could be a blocked duct. To treat it you can:

  • Apply warmth to the affected area for a few minutes before feeding
  • Breastfeed frequently, starting with the affected breast
  • Apply cold to the affected area after feeding.

Read more about treating blocked ducts here.

#7: Mastitis

Do you suddenly feel like you might have the flu? Do you also have a warm, red, tender spot on your breast? If so, you might have mastitis.

It’s important to see a doctor if you think it could be mastitis, because you might need to take antibiotics. As for the treatment of blocked ducts, frequent breastfeeds and the use of a cold application after feeding are important in the treatment of mastitis.

Learn more about treatments for mastitis here.

#8: Thrush

Do you have sharp stabbing nipple pain after feeds, and perhaps shooting pains that go into your breast? If so, you might be experiencing nipple thrush.

Because nipple damage or a bacterial nipple 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.

You can learn more here about nipple thrush.

#9: Ill-fitting Breast Pump Shield

If you are using a breast pump, it’s important to use the correctly sized breast flange. An incorrectly sized flange can result in increased risk of nipple pain and damage.

Using a vacuum setting that is too high can also increase the risk of nipple pain and damage. Also, pressing the breast flange too firmly into your breast can increase the risk of blocked ducts. A lactation consultant can help you work out whether you’re using a breast flange of the correct size.

#10: Biting

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, and this area is covered by your baby’s tongue when your baby is attached and feeding.

However, some babies might bite before they’ve attached or when they’re coming off the breast. This can hurt!

Here are some tips to help stop your baby biting.

In almost all cases, the best way to figure out what’s causing pain is to work with someone who’s skilled in supporting breastfeeding women.

Painful breastfeeding is almost always treatable, so don’t be afraid to get help if breastfeeding hurts.

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Renee Kam IBCLC CONTRIBUTOR

Renee Kam is mother to Jessica and Lara, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.


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