Why does breastfeeding hurt?

Ask other women about breastfeeding in the first few weeks and a common story you will hear is how much it hurts. 

“Oh my, it hurt so bad but I muscled through it and after a few weeks it went away”

“I just tried everything and it never stopped hurting so I had to stop because my baby just didn’t like breastfeeding.”

I’ve heard this from so many women. Breastfeeding hurting is common but not normal.  What does that mean?  It means breastfeeding shouldn’t hurt but due to many reasons it often does.

So If pain isn’t normal why is it common?

Reason #1 

It’s all about the latch, baby.

Take your tongue and run it up the roof of your mouth, this is the palette, feel where the hard part ends and the softer palette begins.  Feel that, this is how far back in your baby’s mouth your nipple should fall.  If your nipple doesn’t fall into this area while breastfeeding than your baby’s hard palette will rub against and pinch your nipple which hurts.  So a really deep latch is necessary for comfortable breastfeeding

Another way to know your baby has a deep latch is look at the corner of your baby’s mouth while latched on to your breast.  It should be open bigger than 140 degree angle.  This angle should be from the corner of where the baby’s lips meet.  I have seen shallower latches be pain free but to effectively drain the breast the optimal angle should be over 140 degrees. Youtube Ameda Latch on for a simple animation to show what I am describing. 

Reason # 2

Engorgement sucks, or more accurately doesn’t let baby suck effectively

Another reason still related to baby latching is engorgement.  Imagine trying to bite a basketball.  That is what it is like for a baby to try to latch on to an engorged breast. 

Like the nipple pain being common but not normal, the same can be said for engorgement.  If during your delivery you have any IV fluids your engorgement can be worse.  Fluids in your body get in-between the milk making cells, fat, ducal tissue, and ligaments to further exacerbate the issue.

Light breast massage all over and Reverse pressure softening can be very helpful to prep your breast for a less painful latch while letting your baby aid in relieving the engorgement.  Reverse pressure softening is where you push fluid and tissue away from the nipple and areola to loosen the tissue ensuring enough tissue to allow the latch to happen. If reverse pressure softening doesn’t help pumping and or hand expression can loosen up the nipple and areola to make latching easier. 

# 3 Oral anatomy

If its still hurting search for answers

If after trying all the tricks and seeing an experienced lactation professional it still hurts, then it might be compromised oral anatomy. 

Common issue under the oral anatomy umbrella is a tongue or lip tie.  Even though I do an oral exam at every consultation my hope is always that I don’t notice a tight lip or tongue frenulum.  (This is also known as lip or tongue tie, you thought it was just a saying huh?)

It’s important to know this may be an issue and seek out assessment and referral from an experienced lactation professional.  FYI most pediatricians are only going to notice or see obvious ties and down play the need for a referral to an experienced provider for assessment and possible revision.

Pain and Discomfort, what’s the difference?

In the first 2 weeks of breastfeeding discomfort is common and normal. What do I mean by discomfort?

On a scale of 1 to 10:  10 being you are about to die from pain and go to the ER and 1 being hmm I feel something but it definitely doesn’t hurt.  3 would be discomfort. 3 or below when breastfeeding is normal and common when latching especially the first few weeks. 

If on a scale of 1 to 10 your breastfeeding experience is above a level 3 for pain than you need to get help.  You need to get help.  Pain = Get Help.  Even if lactation professionals see your latch and say it looks great but it still hurts than you need to get help. One more time if you didn’t catch it,

PAIN = GET HELP NOW

pain scale 

pain scale 

Muscling through pain at the breast does no one any good.  Why?  Babies that cause their mothers pain at latching don’t drain the breast well and can possibly not be getting enough milk.  Mothers that breastfeed through pain also can be damaging their nipples which can cause issues with milk flow and supply. 

I totally understand why women prematurely wean when suffering with nipple pain.  I don’t do martyrdom.  I wouldn’t to continue to do something 8 to 12 plus times a day that hurt.  There is a way to avoid premature weaning.  See someone to help you figure out how to make it stop being painful.  Do this immediately at the first signs of pain.

Breastfeeding is not like lifting weights.  No pain, No gain does not apply. 

Nipple pain is common not normal.

Latch is the number one reason that you experience nipple pain.

Engorgement and compromised oral anatomy can cause and or exacerbate latching difficulties.

Discomfort in the early weeks can be common and normal, but pain is not normal.

PAIN = GET HELP NOW

remember you are more than just the breast 

Cat Halek IBCLC