Breastfeeding Pain Is Not Something You Have to Endure

If breastfeeding is hurting you, the pain is almost always telling you something specific, and in most cases it is something that can be fixed in a single sitting with the right person watching.

Some tenderness in the first few days is common while your body adjusts. Pain that runs through every feed, pain that is worse in week two than it was in week one, cracked or bleeding skin, dreading the next feed before your baby has even woken up. None of that is something you are meant to simply carry until it passes.

The most common cause is a shallow latch. It is also one of the easiest things to correct once somebody shows you what to look for.

On Sunday we published Keji's account of the weeks she spent hiding this from everyone, counting backwards from fifty to survive each feed, smiling at visitors, then crying behind a closed door. This is the part that comes after. What a nurse found in her bedroom on a Tuesday afternoon, in about four minutes, and what you can check tonight.

"Small pain like this, you will get used to it"

If an aunty has said this to you, you are not alone, and she almost certainly means well. She was told the same thing by her own mother. But there is a real difference between your body adjusting and your body being injured, and it is worth knowing which one you are dealing with.

Likely just early adjustment

A pinch or tug at the very start of a feed that eases within the first minute

Mild sensitivity that is improving day by day, not getting worse

Not something to endure

Pain that runs through the whole feed, every feed

Pain that is worse in week two than it was in week one

Cracked, bleeding, or blistered nipples

You find yourself tensing up, holding your breath, or dreading the next feed before your baby has even started crying for it

If the second list sounds like you, please do not wait for it to settle on its own. Go and let someone look.

The most common culprit: a shallow latch

This was Keji's whole problem, and it is the reason behind most breastfeeding pain that gets written off as normal. When your baby latches onto the tip of the nipple instead of taking in a proper mouthful of breast, every single suck presses down on the most sensitive part of you, again and again, ten or more times a day.

It was never her pain threshold. It was millimetres.

What a good latch looks like

Your baby's mouth is wide open before latching, like a yawn, not a small pout

Chin touches your breast first, nose stays free

Lips are turned outward like a fish, not tucked in

You can see more of the darker skin above her top lip than below her bottom lip

Her cheeks stay round while she feeds, not caving in with every pull

What a good latch feels like

A firm tug or pull when she first latches

That eases off within thirty seconds to a minute

No sharp, burning, or stabbing pain once she settles into a rhythm

One thing to try tonight: bring your baby to your breast instead of leaning your breast down toward her, and wait for that wide open mouth before you let her latch. If it starts to hurt, do not grit your teeth and continue. Slide a clean finger into the corner of her mouth to break the suction gently, and try again. It is not stubbornness to reset it three times if that is what it takes.

Other reasons it might be hurting

Positioning. Sometimes the latch itself looks fine but the pain is still there, because your baby's whole body is twisted. Ear, shoulder and hip should line up, tummy to tummy with you, rather than her neck turned to one side to reach you.

Tongue tie. Some babies are born with the tissue under the tongue a little too tight, which makes it hard to latch deeply no matter how well you position them. A midwife, doctor or lactation consultant can check this by looking under her tongue.

Thrush. A yeast infection of the nipple, and sometimes of your baby's mouth. It tends to feel like burning or itching that continues after the feed is over, not only during it. Nipples may look unusually pink or shiny, and you might see white patches in her mouth.

Vasospasm. Less talked about, but real. A sharp, throbbing pain, often after a feed rather than during it, and nipples that change colour, white then blue then red. Easy to dismiss as sensitivity, but worth mentioning to a health worker.

Mastitis. A blocked duct that has become inflamed, and sometimes infected. This one can move fast, so it belongs in the list below.

None of these are things to diagnose yourself at 2am with your phone torch. They are things to bring to someone trained to look, because the right fix depends entirely on which one it is, and treating the wrong one wastes time.

When to stop enduring and go back

Go back to the hospital where you delivered, your nearest primary health centre, or a certified lactation consultant if you notice any of these:

Fever, especially alongside breast pain

A hot, red, painful lump in the breast, or a patch of skin that is warm and tender

Bleeding or cracks that will not heal, even after a week of working on the latch

A sudden flu-like feeling, body aches, chills, feeling unwell all at once, which can be an early sign of mastitis

Your baby is not gaining weight, or seems unsettled and hungry all the time no matter how often she feeds

You are dreading every feed, and it is starting to affect how you feel about being with your baby

That last one belongs on the list as much as the fever does. Dread is your mind doing the same job pain does in your body. It is telling you something needs support.

Small things that help while you sort out the cause

After each feed, express a few drops of your own milk onto sore or cracked skin and let it air dry. Skip this one if thrush is suspected, since yeast feeds on milk. Ask a health worker first.

Change nursing pads often so the area stays dry, especially in the heat

Try different positions across the day, cradle, football hold, lying down, since each one changes where the pressure falls

Keep soap away from the nipple itself, as it dries out skin that is already trying to heal

These will make things more bearable. They are not a substitute for finding out what is actually causing the pain.

The sentence worth saying to yourself

Before that nurse ever walked into her bedroom, Keji had already decided, quietly and on her own, that suffering through it was simply what a good mother did. Her own mother had said, almost in passing, "I breastfed five of you, I never complained." Keji folded that sentence into herself and stopped asking for help.

It took a stranger watching her feed for four minutes to say the thing that changed everything.

Pain is information. It is not a verdict on your mothering.

You do not need to wait for a crisis to say the same thing to yourself. If a feed is hurting you, you are allowed to say so out loud, to your husband, your mother, a nurse, anyone, long before you find yourself sitting on a bathroom floor with your hands over your ears.

Breastfeeding is natural. Learning how to do it, for you and for your baby, usually is not. That is not a reflection of how much you love her, or how capable a mother you are. It is simply something worth getting help with, the same way you would with anything else this important.

Read Keji's full story here.

A note from iMumZone

This article is general information and is not a substitute for advice about your own situation. If breastfeeding is painful, go back to the hospital or clinic where you delivered, visit your nearest primary health centre, or ask to be referred to a certified lactation consultant. If you are feeling low, anxious or unlike yourself since giving birth, and it has lasted longer than two weeks, that is worth seeing a doctor about too. Asking for help early is not failure. It is care.