How to Deal with Breastfeeding Pain

​How to Deal with Breastfeeding Pain: All You Need to Know​​

​Breastfeeding can be a wonderful time for bonding between a mother and her newborn, but sadly this isn​'t always the case.

If this is your first baby, there is a high likelihood that you resent feeding time instead, all because of the breastfeeding pain you experience.

After reading this guide​, you will learn all that you can do within your power to remedy this issue.

​Is Breastfeeding Painful For Everyone?

​No, under perfectly fine circumstances, breastfeeding is not supposed to be painful [1].

Fortunately, not every breastfeeding mother will have to endure the pain associated with various issues that may arise.

However, what is clear is that most women that experience pain from breastfeeding are first time mothers with little to no experience in proper technique or feeding frequency.

While there is no way to predict if you will experience pain as a result of feeding your little one, you can still do the necessary research to minimize your risk of suffering from it.

​Is It Safe To Breastfeed While In Pain?

​In most cases, it is perfectly fine to breastfeed even if you are feeling active pain [2], as it is often advised to continue breastfeeding due to its ability to help in some cases.

For example, if your pain is caused by a blocked duct or engorgement, you need to continue regularly feeding to experience relief.​ 

It is highly advised against stopping breastfeeding unless so advised by your physician.

​In terms of harm to the baby, very rarely does it pose a problem. These include a visible abscess, or active bleeding from the nipple.

​Where Is Pain Felt While Breastfeeding?

​Though you may think that all types of breastfeeding pain manifest as just generalized discomfort, its symptoms may be manifested in one of two different areas [3].

These are:

​1. Nipple Pain

​Nipple pain is the most common association with pain during breastfeeding, and luckily, is not always indicative of a more serious problem.

With the right know-how, nipple pain can become a non-issue, allowing for uninterrupted feeding sessions.

2. Generalized Breast Pain

​If your nipples aren​​'t affected, but you feel pain in the actual breasts, while being more difficult to manage, there is still hope yet.

Most mothers that experience breast pain find that it is transient (lasting only about a month in feeding) and is much more common if this is your first baby.

​What Are The Causes Of Breastfeeding Pain?

1. Mastitis

​Mastitis is an inflammatory condition typically caused by bacteria and which cause infection of the milk ducts and glands [4].

Mastitis occurs most frequency when a woman is lactating, explaining why so many breastfeeding moms experience this.

Though you will typically need to receive some form of antibiotic treatment [5] for mastitis, it is generally safe to continue breastfeeding (if you can tolerate it) based on the guidance of your physician.

2. Thrush

​Thrush is a fungal infection caused by the fungi Candida albicans[6]. This is the same yeast that causes vaginal yeast infections, and is much more likely to occur to mother and baby following treatment with antibiotics.

Though thrush may start off with minor itching and inflammation around the nipples, it can quickly get very painful and tender, with lesions resembling canker sores forming around the nipple.

Thrush also appears in your baby​'s mouth as small patches of a white substance which do not wipe away easily.

3. Breast Engorgement

​Engorgement is a source of much distress to new mothers that does not need to be so [7].

​It is actually a good sign, as it is indicative of milk production increasing to meet the needs of the baby. Engorgement is normal about 2-5 days after birth.

One of the best ways to take care of engorgement is to feed often. If full breasts prevent adequate nipple visibility, slight manual expression can help. Engorgement usually passes after a few weeks, given that feeding frequency is kept up.

4. Cracked Or Swollen Nipples

​Nipples are extremely sensitive to topical damage, especially due to poor latching technique by the baby.

Appropriate latching technique helps reduce “pulling” on the nipple or areola, which may damage the skin surface and give rise to cracks [8].

Swollen nipples follow the inflammatory process after small cracks have developed, and may later progress to infection if not managed appropriately.

5. A Tongue Tied Baby

​A tongue-tied baby displays greater difficulty while feeding compared to normal babies, owing to limited mobility of their tongue.

The muscles attached to the back of the tongue restrict its free movement, which in turn results in forced feeding and suckling by the baby [9].

A simple procedure can be done by your pediatrician to relax the muscles constricting the tongue, after which you should notice greatly improved feeding and resolved pain.

6. Your Breast Pump

​Most versions of commercially available breast pumps can be pressure adjusted to optimize the pumping rate of milk.

However, what needs to be quickly made clear is the fact that higher vacuum pressure does not equate to increased milk expression [10].

Rather, it is more likely to increase the risk of nipple damage. Experiment with finding the best pressure setting, and use that only.

Is Pain While Breastfeeding Expected?

​A new mother is likely to be very sensitive to the sensation of pain, regardless of how small it may be.

For example, during the first minute or so [11] of breastfeeding, it is normal to experience a slight pulling pain from the bay adjusting to a proper latch position.

Besides that, other causes of pain while breastfeeding could include a blocked duct, or an active thrush infection that causes damage to the nipple surface.

Why Do I Experience Pain After Breastfeeding?

​Pain after breastfeeding is an occurrence that is​ common during the first two weeks after birth, following activation of the milk ejection reflex (MER).

Since the release of oxytocin by the mother also stimulates contractions within the uterus (and hence, feels a bit like menstrual cramps).

This pain, also referred to as ​"let down​" pain [12], usually occurs following breastfeeding when milk production is stimulated to refill depleted stores. This pain subsides after 2-3 weeks following birth have passed.

But there​'s more- pain post feeding could also be the result of a thrush infection. Though this manifests more as a burning discomfort, if left to get out of hand profuse swelling and deeper pain is likely.

Is Breastfeeding Pain Under Arms Normal?

​If you experience pain and swelling originating from under the armpit region, a blocked milk duct or mastitis is likely the culprit [13].

How do you differentiate the two? Generally, mastitis manifests with more symptoms resembling that of a flu, including fever and generalized malaise.

A blocked duct will have localized pain, and is remedied in most cases by massage and application of moist heat during the day and while feeding. The pain should resolve within 7 days’ time if this was the underlying cause.

​Breastfeeding Pain Management: What Can I Do?

​Depending on the specific origin of your pain, what you need to do to fix it will vary. However, outlined below are the most common ways to relieve discomfort.

1. Master The Latch Technique

If breastfeeding pain persists intermittently well after the birth of your baby, poor latch technique could be the problem [14].

Not only could this cause frequent pressure pain from engorged breasts, but also your baby getting insufficient milk.

Proper latch technique also helps to relieve symptoms of engorgement and can help treat/prevent other causes of breastfeeding pain in the first place.

2. Wear An Appropriate Bra

​Though this should be self-explanatory, it still occurs that many cases of pain during breastfeeding are caused by an ill-fitting bra.

While breastfeeding, you will have inevitably noticed that the size of your breasts have increased significantly, and warrant a change of size in your bra.

Bras that have become too tight can contribute to blocked milk ducts, or formation of lumps that are tender to the touch.​

​​The fix?

Purchase a size up [15] (or as necessary) it should be free-fitting, yet offer decent support.

3. Express Milk

​Manual milk expression is one of the best tools for dealing with breastfeeding pain, for a multitude of reasons. However, it is not the means to an end.

For example, if experiencing engorgement, frequent milk expression can worsen it, as the body believes that all the milk is being used, and hence, attempts to produce even more [16].

Instead, use expression of milk to your advantage. Pump just a little bit at a time; effectively relieving the pressure but without causing rebound engorgement.

In like manner, if suffering from cracked nipples or thrush, milk expression can still allow your baby to get breast milk while allowing you a bit of time to heal.

4. Use Heat And Cold

​Like many other soft tissue injuries, pain to the breast and nipple tissue can be managed by appropriate use of heat and cold compresses, even though their application may vary a bit.

For example, the use of a warm compress is advised before breastfeeding, as this can help improve the free flow of milk out of the nipple. This can help clear duct blockages as well [17].

A cold compress used after feeding can help offer much-needed pain relief and anti-inflammatory action, until the next feeding session comes along.

5. Use Appropriate Anti-Microbial Preparations If Necessary

​Sometimes, pain is indicative of an underlying infection which needs to be treated to be resolved.

For example, thrush may require use of the ​prescription medication Nystatin, whilst inflamed nipples can be managed with topical antibiotic preparations [18].

In cases such as mastitis, your physician will need to prescribe antibiotics for you to consume by mouth, for durations up to 2 weeks.

6. Use Oral Pain-Killers

Over the counter pain medication that include Ibuprofen or Acetaminophen are generally accepted as safe for relieving pain (if unbearable), but it is advised that you first consult your Pharmacist or Physician before consuming them.

What Can I Do To Do Get Pain Relief For Nipples?

​If your nipples are the source of pain while/ after breastfeeding, the ideal strategy for healing involves soothing inflammation while still being able to breastfeeding.

Yes, this is not ideal, but withdrawal from feeding to allow healing is actually counterproductive, as you may then develop symptoms from clogged ducts, for instance.

Try the fixes outlined below:

Treating Pain From Cracked Nipples

​Cracked nipples can occur by themselves, or as a result of another condition. Regardless, it is imperative that you treat the affected nipples themselves, in addition to an underlying condition (if any). Try the following:

  • ​Allow Nipples To Air Dry - after feeding, allow nipples to dry. Constantly placing nipples in a wet/damp bra will only keep them creased most of the time, increasing likelihood of a crack occurring.
  • Feed From The Injured Nipple Secondarily - feeding from the other uninjured nipple first, then switching to the injured nipple is a good way to prevent milk retention issues and minimize pain.
  • Don't Wait Too Long To Feed - often times, a baby's hunger can result in nipple cracks forming since a hungry baby is more likely to feed forcibly. Schedule feedings at regular intervals.
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    Apply Lanolin [19] - lanolin is a natural fat obtained from sheep's skin that has soothing properties, but which carries the potential for allergic reactions. Be sure to use only highly purified/ pharmaceutical grade lanolin topical preparations for soothing cracked nipples.

How Do I Manage Pain From Bleeding Nipples?

​Bleeding nipples usually occur when cracked nipples worsen. In addition to undertaking cracked nipple treatment protocol, you also need to:

  • ​Apply An Antibiotic Ointment - over the counter preparations such as Bacitracin or Polymyxin are preferred, and are generally safe in the small residual volumes that may be left prior to feeding. Antibiotic ointments are necessary to prevent development of infection if bleeding ensues.
  • Apply A Saline Wash - saline wash serves the dual purpose of being mildly analgesic (pain relieving) and killing bacteria that may be present around the nipples. A Saline solution will not burn, and is safe for baby to feed on afterward.

Do Milk Blisters (Blebs) Cause Pain While Breastfeeding?

​A milk blister, also known as a ​"bleb​" occurs when a tiny bit of skin grows over a segment of the nipple, trapping milk underneath it in the process. While small, it can cause pain when touched, as it triggers an inflammatory response.

​How Do I Treat A Milk Blister?

​The best treatment for a painful milk blister is application of moist heat (such as a warm washcloth) to the affected nipple several times a day and before feeding [20].

This helps to soften the skin and eventually popping the blister on its own. Usually, once the blister has popped, the skin underneath will need treatment in a manner similar to that used for treating cracked nipples.

It is not uncommon for milk duct blockages to occur as well, so expression with a pump or manually is necessary to help stimulate back normal milk production and reduce pain.

​Final Words

​In many cases, breastfeeding pain is only self-limiting, and can be resolved with frequent breast milk expression and using moist heat compresses.

​If you experience flu-like symptoms, or notice signs of an infection developing, ​don't hesitate to consult your healthcare provider.

​Pain associated with breastfeeding does not need to be the reason you wean your baby early, as there really is nothing that can match the nutritive superiority of mother's milk.

Did this article help address your source of breastfeeding pain?

We sure hope so. We feel strongly that pain related to feeding can be easily managed if you know what to do, which is why this article was compiled.

Share with someone you know that can benefit from reading this and let us know your comments below!

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