Breastfeeding pain – here is what you can do
1. Breast engorgement
Breast engorgement can have many causes, however the most common are incorrect positioning and latching, irregular feeding, schedule-feeding, expressing too frequently, not being able to breastfeed your baby for any reason and weaning from the breast too quickly. Breast engorgement is an imbalance between the amount of breastmilk being made and the amount being removed from the breast. Your breasts will feel heavy, hard, warm and sensitive – as if they are about to burst!
Solution: Breast engorgement will usually improve if you continue breastfeeding. To help overcome breast engorgement, first check with your doctor or lactation consultant to ensure your baby is positioned and latched correctly at the breast to enable effective milk transfer. Aim to breastfeed every 1.5-2 hours during the day and every 2-3 hours at night. Allow your baby to finish feeding on one breast before transferring to the other. Avoid the use of bottles and pacifiers.
Use a nursing bra that doesn’t restrict your breasts, vary your breastfeeding position, keep your breasts warm and always get your baby to feed from the painful breast first. Massage the breast lightly during feeding to empty the milk ducts. Contact your doctor or lactation consultant if your breastfeeding pain has not improved after a day or two.
2. Breast infection or inflammation/ mastitis
If you have flu-like symptoms, such as a high temperature, tiredness and achy muscles, and are experiencing pain in a breast that is swollen and hard, you may have a breast infection or inflammation, also known as mastitis. Usually only one breast will be affected. Mastitis is most often caused by a build-up of milk in the breast from unresolved engorgement. It can also be caused by incorrect latching at the breast or infrequent feeds.
Solution: If you experience mastitis, be sure to speak with your doctor or lactation consultant to ensure your baby is correctly positioned or latched at the breast.
Try to get as much rest as you can. Make sure you eat and drink properly. Continue to breastfeed, using the affected breast first. Massage the breast lightly when feeding.
If you experience flu-like symptoms, contact your doctor. You may need antibiotics to resolve the problem. Mastitis can also change the taste of breastmilk, and babies may occasionally refuse to breastfeed. If this occurs, it is important to pump from the affected breast until the mastitis is resolved.
Sore nipples are the most common complication associated with breastfeeding as well as the most common reason why women stop breastfeeding.
3. Sore nipples
Sore nipples may be a sign that your baby isn’t properly positioned and latched at the breast. Sore nipples are the most common complication associated with breastfeeding as well as the most common reason why women stop breastfeeding. They occur most commonly during the first few weeks after birth.
Solution: Ask your doctor or lactation consultant to observe a feed to ensure your baby is correctly positioned and attached at the breast. Try using different feeding positions. Ask your doctor or lactation consultant to check for tongue-tie, which may be impacting the way baby is latched at the breast. Use a lanolin-based nipple cream to help heal the nipples and consider using nipple shields when feeding to provide an extra layer of protection. Breast milk has a healing effect, so you can also massage a little breast milk into your nipples and areolas after breastfeeding.
4. Thrush infections
Breastfeeding pain is sometimes caused by a thrush infection. This is caused by the Candida organisms naturally present in your baby’s mouth multiplying excessively and causing a fungal infection that spreads to your nipples, areolas and milk ducts. A fungal infection may cause an irritated, burning and itching sensation in your nipples/areolas. Your nipples may develop blisters and cracks, and your areolas may become swollen, weepy and flaky. A thrush infection in your milk ducts may cause pain, burning and itching inside your breast. If thrush is the cause of your pain it will also be noticeable in your baby. You will see white patches on the roof of the mouth and tongue.
Solution: If you suspect either you or your baby have oral thrush, contact your doctor to receive medication for both you and your baby. It is important that both of you are treated to prevent a reoccurrence.
What you also can do: Fungi thrive in damp conditions, so try to air your breasts frequently and be meticulous about your hand hygiene. Use breast pads to keep the inside of your bra dry and clean. Sterilize pacifiers, nipple shields, reusable breast pads, your baby’s teething toys, feeding bottles, etc., on a daily basis. Also, wash your underwear, bra and towels frequently.
5. Leaking breasts
It’s normal for a new mom’s breasts to leak milk at first. This often happens while you’re feeding your baby from the other breast.
Solution: Breastfeed frequently. The more often you breastfeed, the less chance that your breasts will leak. If you’re leaking a lot, there are special breast shells that you can get to collect the milk. If you leak even when you’re not breastfeeding, you can buy breast pads to put in your bra.
6. A baby who bites
Ouch! It can really hurt when your baby bites your nipple. It may even make you reluctant to breastfeed. Biting most often occurs when your baby is starting to teethe, which can be anywhere from three months onward.
Solution: Stop breastfeeding every time your baby bites to show that it hurts. Be ready to insert your finger gently into the corner of your baby’s mouth to loosen their grip on your nipple. Say “No” to your baby in a firm voice and then continue to feed.
When your baby refuses to feed, it could be their way of telling you that something is wrong.
7. When your baby refuses to feed
When your baby refuses to feed, it could be their way of telling you that something is wrong. Your baby may have a cold or an ear infection or could be experiencing the discomfort of teething. The flow of your milk may also be slower. Your baby may also simply be distracted by other things.
Solution: If you suspect that your baby is ill, contact your doctor. If you find that your baby is easily distracted, try breastfeeding in a calm space with subdued lighting. Also, consider using a breastfeeding necklace, which helps keep your baby focused at the breast. Try to breastfeed when your baby is very tired, vary your breastfeeding position, stand or walk while you breastfeed, and give your baby plenty of skin-to-skin contact. If you think your baby is refusing to feed because of teething issues, apply a little teething gel prior to feeding to help numb the gums.
8. Too little milk
It is very rare to have too little milk, but it’s understandably stressful when your baby seems to be feeding all the time without gaining weight or when your breasts don’t seem as full as they did at first. This is often due to breastfeeding too little, which may impair the let-down reflex. It could also be due to incorrect positioning and latching, tongue-tie, supplementing with formula, the use of medication or previous breast surgery.
Solution: Increase your milk production through a lot of skin-to-skin contact with your baby and by breastfeeding more frequently. This stimulates the hormone oxytocin, which is important for milk production. If possible, take your baby to bed with you and spend 24 hours focusing purely on skin-to-skin, feed every 2 hrs during the day and every 3 hours during the night. Switch sides every 5 minutes so both breasts are being stimulated and pump for 15-20 minutes after each feed.
If the feeling that your baby is not getting enough milk is stressful for you, don’t hesitate to contact your doctor or lactation consultant.
9. Too much milk
If you’re producing too much milk, your baby may struggle to empty your breasts, making them constantly feel tight and uncomfortable. This may be caused by a strong let-down reflex. Your baby may find it difficult to feed when your milk comes too fast and in large quantities. Oversupply can also be caused by too frequent pumping or not emptying one breast before moving onto the other.
Solution: Oversupply will normally settle down by itself over time. You can try block breastfeeding, which involves feeding only from one breast for a period of 3-5 hours. Contact your doctor or lactation consultant to get specific advice about this method. The method is based on the principle that a full breast doesn’t produce milk and is one way for you to decrease your milk production and milk quantity.
If you have a strong let-down reflex, you can express some milk by hand before letting your baby feed. This prevents the milk from flowing as fast. Gently massage your milk ducts to release the pressure. Also, try different breastfeeding positions. Lying on your side or holding the baby more upright while you breastfeed may help to reduce the pressure.
Sources: babycenter.com, womenshealth.gov
This article has been reviewed by Katie Hilton, qualified midwife and health visitor, UK.
Don’t hesitate to ask for help and advice
Always contact your doctor if you suspect that you or your baby is unwell. Also, contact your doctor if you suspect that your baby isn’t getting enough milk or if you experience persistent breastfeeding pain.
If you have questions or need help and advice, contact your doctor or lactation consultant.