Does Breastfeeding Hurt?

The Causes of Pain and Discomfort: What's Normal?

A new born breast feeding
Should it hurt to breastfeed?. Catherine Delahaye / Getty Images

Breastfeeding shouldn't hurt. It should be comfortable. It's even an enjoyable experience for many women. However, during the first few days of breastfeeding, there may be some nipple tenderness. This mild pain is normal and shouldn't last very long. You may also feel a bit uncomfortable when your breast milk comes in during the transitional stage of milk production. Breast engorgement is common at this point, and when your breasts become swollen and full of breast milk, it could hurt a little.

But after the first few weeks, as long as your baby is latching on correctly and breastfeeding often, you shouldn't be in any pain. 

What Should Breastfeeding Feel Like?

As mentioned above, a little nipple tenderness is normal when your baby first latches on. Then, as your child breastfeeds, you may feel the suction of the latch and a gentle tugging or pulling sensation, but it shouldn't hurt. There may also be some mild pain or a tingling that feels like pins and needles when your breast milk is released and begins to let-down.

Uterine Contractions (After Pains)

After pains are uterine contractions that feel like very strong menstrual cramps. These contractions shrink your uterus back down after the birth of your baby. Breastfeeding helps this process because when your baby latches on and nurses, your body releases the hormone oxytocin. Oxytocin then causes the muscles of the uterus to squeeze together or contract.

When you feel these contractions while you're breastfeeding, it can hurt a bit, and it might be accompanied by a gush of blood. The pain and bleeding that come with these contractions are normal and nothing to worry about. And even though your uterus will continue to contract and shrink down for the next six weeks, you will only feel the pain for a few days.

 If you need a pain reliever during this time, your doctor can prescribe one for you. 

What Can Cause Breastfeeding Pain?

Just because breastfeeding shouldn't be painful, doesn't mean it can't be. Sometimes painful breastfeeding issues do arise. From a poor latch during the first few weeks, to problems that develop months later, there are certainly a few reasons why breastfeeding might become painful. And since you shouldn't expect to feel pain, it's often a sign that something is not quite right.

If breastfeeding hurts, don't wait to get help. Call your doctor or a lactation professional to talk about what's going on with you. The faster you can identify what's causing the problem, the faster you can treat the issue and prevent it from getting worse. Here are some of the reasons that breastfeeding might become painful. 

1. A Poor Breastfeeding Latch

If there's more than just mild nipple tenderness in the first few weeks, it's usually the result of a poor breastfeeding latch. When a baby isn't latching on properly, he can't breastfeed correctly on the breast and nipple, and he can't remove the breast milk from the breast as well.

The poor seal can lead to sore nipples, and the ineffective removal of breast milk can lead to breast problems. But, once you fix your baby's latch, the pain will usually go away.

2. Breast and Nipple Pain

Breast and nipple pain can arise for many reasons. If you have sore nipples or pain in your breasts, you'll want to try to figure out the cause and treat any issues as quickly as possible to prevent them from getting worse. Here are some of the common causes of breast and nipple pain in breastfeeding mothers.

  • Sore Nipples: Sore nipples can develop if a baby doesn't latch on well, or if the child is not removed from the breast correctly. An infection such as thrush, or a skin condition such as eczema can also cause nipple pain. Biting, vasospasms, nipple blebs, blisters, and not using a breast pump correctly are other causes of sore, painful nipples.
  • Breast Engorgement: Swollen, tender breasts are common during the first few weeks of breastfeeding, but they can also develop long after breastfeeding is established and going well. If you have an overabundant supply of breast milk, engorgement may be a constant issue. Engorgement may also arise if you miss a feeding or wait too long between feedings and when your baby begins to sleep through the night.
  • Plugged Milk Ducts: Plugged milk ducts are small, hard, painful, lumps filled with breast milk. They can block the narrow milk ducts and the flow of breast milk in the breast. Plugged ducts can develop if one area of the breast is not draining well, if a feeding is missed or postponed, or if something is putting pressure on the breast such as a tight underwire bra.
  • Mastitis: Mastitis is a breast infection. Bacteria can enter your body through cracked nipples causing a fever and flu-like symptoms as well as swelling and pain in your breast. Mastitis results from missed feedings, plugged milk ducts, thrush, excessive pressure on your breast tissue, and weaning too quickly.
  • Thrush: Thrush is a yeast infection. It's the overgrowth of the fungus Candida albicans. Candida is naturally present in your body, but when it grows out of balance, it can cause painful problems. Yeast can grow on your nipples, on your breasts, and in your baby's mouth. It may feel like a burning, shooting, or stabbing pain, and the skin around your nipples or breast may be itchy, red, shiny, or flaky. Thrush is more likely to become an issue if you wear wet breast pads too long, take antibiotics, or start using birth control pills. It's also more likely to develop if you're prone to vaginal yeast infection, you have diabetes, or your baby gets yeast-related diaper rashes.

3. Baby Teeth and Biting

The thought of breastfeeding a baby with teeth may be a little scary, but you don't have to wean when those little teeth begin to erupt. Your child won't be able to bite you while she's latched on and breastfeeding because her tongue will be covering her bottom teeth. But, some babies do bite down on the breast when the feeding is over, and yes, it can hurt.

To help prevent biting, remove your little one from your breast as soon as the feeding is over. And, if your child does bite you, gently but firmly tell her “No” and remove her from the breast. Once a child understands that biting down gets her taken off the breast, she'll be less likely to do it. 

Painful Breastfeeding and Early Weaning

When breastfeeding is comfortable, you can enjoy the experience with your baby, and you're more likely to breastfeed for a longer period of time. But, when it hurts, it's much more challenging, and you might start thinking about giving up. Painful breastfeeding is one of the risk factors for early weaning, but it's also almost always something that can be treated successfully.

So, before you decide to stop breastfeeding, talk to your doctor or a lactation consultant. Your healthcare provider can identify the cause, solve the problem, and relieve the pain. If you need pain medication to get you through, there are safe options for breastfeeding mothers. And, in some cases, such as mastitis and plugged ducts, breastfeeding more often can actually help make the situation better, and weaning may make it worse.

Of course, there are always times when weaning is the right choice. If you're overwhelmed, exhausted, and breastfeeding is too painful and just not working out, you have to do what's best for you and your family. So, if you do decide to wean, you don't have to feel guilty. Just know that you tried, and you did the best you could.

Sources:

Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol# 4: Mastitis. 2008.

Brent, N. B. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clinical Pediatrics. 2001. 40(9), 503-506.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.

Lewallen LP, Dick MJ, Flowers J, Powell W, Zickefoose KT, Wall YG, Price ZM. Breastfeeding Support and Early Cessation. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2006. March 1;35(2):166-72.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.

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