7 Reasons For Breast Pain While Breastfeeding (+ Quick Fixes)

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From the moment you give birth, there is a tight connection between you and the baby. It gets even more profound when you start breastfeeding. However, oftentimes a new mom is experiencing some discomforts, like sore or cracked nipplesб or pain in the breast that is sometimes excruciating and discouraging. These are one of the most common breastfeeding problems inexperienced first time moms come up with (and I wasn’t an exception!), thinking there is something wrong with them.  

Logically, every woman would think (while pregnant) that breastfeeding is going to be a piece of cake, because it’s natural and based deeply on the genetic level. This is true, but only to some point.

The biggest problem nowadays is that many women hope for a trouble-free breastfeeding. I’m, on the other hand, encouraging you to be more down to earth and educate yourself about breastfeeding. You really have to learn how to breastfeed. Know all the pitfalls that can come up on your way. Know how to deal with them. Understand the whole process of breastfeeding (which is absolutely amazing and I still can’t believe our bodies are able to do this!)  

I highly recommend subscribing for Stacey’s Milkology course. She is a Certified Lactation Educator and a mom of 3. She has already helped thousands of nursing moms establish a successful long-term breastfeeding journey and will help you, too! Let me just tell you, after watching The Ultimate Breastfeeding Course, I can undoubtedly say, the knowledge and assurance I acquired afterwards is so much more palpable than what I thought I had before (after the course I visited in the clinic close to my house).

Getting back to the topic. So why can you experience breast pain while breastfeeding? While it is normal to feel some discomforts at the start of your breastfeeding journey, constant breast pain is a red flag! Breast soreness while nursing may be caused by natural adaptation of milk ducts to the process of lactation. However, there can be more serious problems that require you to act appropriately. Here are the possible reasons for breast pain and quick fixes to relieve it.

7 REASONS WHY YOUR BREAST HURTS WHILE BREASTFEEDING

Disclosure: this article should not be construed as medical advice. Contact your health care provider with any concerns about your health.

1. Natural Causes

Woman’s body experience a great deal of changes during pregnancy. Breast changes are probably the first things you notice even before you find out about your pregnancy. The mammary glands swell, the nipples become darker, you may also feel some leakage (usually only drops) of colostrum from the nipples.

With the birth of a child, the postpartum changes in the body go even more intensively. Now the main role is played by prolactin – “the hormone of motherhood” and oxytocin – “the hormone of love”. Breast milk is produced and extracted from the breast, replacing the colostrum, thanks to these hormones. During this period many mothers mark unpleasant, and even painful sensations in their breasts.

They are usually related to the following factors:

• Fast inflow of milk (Overactive letdown). Many mothers describe it as “bursting” or “tingling” sensations in the breast. Some may even feel pain;
• Adaptation of tender nipple skin to the process of breastfeeding. It manifests itself as painful sensations when the baby latches on and the formation of small cracks on the nipples;
• Painful Letdowns. The lactation is established within 3 months postpartum, so the overactive letdowns and some leakage of milk can persist during this time. Right after you give birth you may experience discomfort in the breast and nipple area while you letdown, as well as in the lower abdomen (because your uterus is contracting to get back to its pre-pregnancy shape (God is it painful! But only for a couple of days, I promise!). Over time, you will develop a reflex when you experience the letdown only when you start nursing. If you have a wide gap between the breastfeeding sessions, you’d better pump some milk to avoid the “bursting” sensation, which is NO FUN!

2. Poor Latch

According to the experience of lactation consultants, this is the main cause of lactation disorders. When a baby latches the nipple incorrectly, the mother experiences acute pain at the beginning of the feeding. You can’t breastfeed with the poor latch, as this negatively affects not only you, but your baby as well:

1. he cannot manage to suck breast milk properly which may lead to formation of a clog in your milk duct – super painful and you surely don’t want that!
2. he gulps and swallows a lot of excess air in the process of nursing, which may lead to excessive gas and severe colics.

If you noticed that your baby has a poor latch (better call a lactation consultant and let her examine the latch to make sure there is a problem), you need to correct it ASAP!

What you can do to help your baby latch on correctly:

• Wait until the baby opens his mouth wide. He will do it reflexively if you stroke your nipple along his lower lip;
• Pull the baby’s head towards you. The mouth of the newborn should seem to cover the whole nipple. You will only see a small part of the areola. The nipple in this case will be at the root of his tongue, which is the right position that can’t hurt your nipple;
• You can also stretch the skin of the areola by holding your thumb at the top of it, and the index finger at the bottom. Put the nipple into your baby’s mouth, release the breast and it straightens itself, ensuring the right latch.

Physiological reasons for a poor latch:

1. Tongue-tie. In this case, you should consult a pediadontist, he will surgically resolve this issue in a couple of minutes. Here’s a great article with everything a new mom needs to know when breastfeeding a tongue-tied baby.
2. Cleft palate. Although this is rare, you have to know what measures you can take to make breastfeeding work. Here’s the ABM Clinical Protocol #18: Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate.

3. Nipple Damage

Due to lack of experience in breastfeeding, a new mom often deals with cracked nipples. They cause severe pain during the feeding sessions.

Nipple damage can happen for the following reasons:

1. Incorrect latch when the baby sucks only a part of the nipple without an areola. This can lead to mechanical injuries  resulting in cracks;
2. Excessive breast care. Too frequent breast washing erases protective lipids, which all lead to drying and thinning of the skin on the nipples;
3. Wrong hand expressing technique. Sometimes a nursing mom has to express breast milk. For example, if she needs to boost her milk supply, releave a clogged milk duct,  leave the baby for a while, or finish breastfeeding. Hand expressing is not always easy, especially when you have never done it before. You may squeeze your breast too much or make too many manipulations around the nipple area that may result in cracked or bleeding nipples. If you need to express breast milk, try using a breast pump. However, frequent pumping can also cause nipple damagea. Here’s a great article with the best pumping tips a mom should know;
4. Abrupt termination of breastfeeding session. Nipple cracks occur when a mom sharply pulls the nipple out of the baby’s mouth in order to complete or interrupt a nursing session. Usually, the baby relaxes his mouth and releases the nipple by himself when he is satisfied. If you need to interrupt the breastfeeding process abruptly, you should carefully insert a clean little finger into your baby’s mouth so that he let go of your nipple. Only then it is safe to remove the nipple from the baby’s mouth.

If you noticed some cracks on your nipples, here’s what you can do to heal them.

4. Thrush

Cracks and abrasions on the nipples easily become a place for the spread of fungal and staphylococcal infections. In this case, a whitish coating is formed on the nipples, as well as the gums, cheeks and tongue of the child. The baby begins to cry more often and refuses to eat.

A nursing mother experiences the pain not only during the breastfeeding, but also in betweeen the nursing sessions and while pumpimg or hand expressing breast milk. The worst part is that if the infection is not taken care of immediately, it may penetrate  deeper and affect the milk ducts.

Thrush can be a result of hormonal changes, reduced immunity and non-compliance with hygiene rules (either rare or unnecessarily frequent washing of the breast).

La Leche League has a great article explaining all you need to know about eliminating thrush in mothers and babies in detail.

5. Lactostasis (clogged milk ducts)

Lactostasis is also known as plugged milk ducts, when breast milk is unable to evacuate from the breast effectively thus forming a clog.

Common causes of lactostasis are the following:

• Insufficient and irregular emptying of the breast due to improper latch, bottle feeding or cracked nipples
• Holding your breast when nursing: the fingers can pinch some milk ducts, so that they are not completely emptied
• Tight bra (sports bra may cause a clog as well)
• Sleeping on your stomach
• Oversupply
• Lack of sleep, stress, and exhaustion (everything that leads to low immunity)
• Breast injury
• Hypothermia (when you get really cold)

How do you know that you’ve got a clogged duct?

1. Your breast becomes firm (and remains like that even after the feeding). Usually it is not the whole breast, but the place where the plugged duct is.
2. You may have a hot red spot on your breast located in the place of a clog.
3. Letdowns feel weird: more intense with painful and tingling sensations. Actually, they feel terrible when you have a clogged duct!
4. Breastfeeding hurts a lot. It doesn’t get better after you finish nursing. No kidding.
5. Body temperature may rise (for me it was one of the first symptoms. I thought I caught a cold but I didn’t have any symptoms other than fever. Only by the end of the day, when I realized every feeding was kinda painful and I found a red spot on the breast, did I get that I had lactostasis and that was the initial reason for a raised body temperature).
6. You feel sluggish.

Can you breastfeed with lactostasis (clogged ducts)?

Yes, absolutely! You have to breastfeed as much as possible to relieve and get rid of lactostasis. Regular and frequent nursing can help you cope with a clog in 2-3 days. However, pain may persist after complete emptying of the mammary glands. Long-lasting lactostasis can cause uninfected mastitis.

How to treat lactostasis?

Long story short:

• Take a hot shower
• Massage your breast and use hand expression to relieve a clog
• Apply a cold cabbage leaf to the area of the clog
• Breastfeed as much as possible
• Rest as much as possible!

Here’s a great in-depth (and quite popular) article on my blog about 8 ways you have to try to relieve a clogged milk duct. I wrote it based on my experience of treating a reccurent clogged ducts and I hope it helped many many women manage this problem successfully.

6. Mastitis

Mastitis is an inflammation of the breast tissue that typically occurs during breastfeeding. Woman’s breast becomes abnormally swollen, red and painful during mastitis. The desease can develop due to lactostasis (clogged milk ducts), as well as cracked nipples, because infection can easily penetrate into the breast through the cracks. However, mastitis can also be uninfected, which typically starts if a nursing mom had a clogged milk duct that was left untreated for a long time.

Symptoms of mastitis

• swelling and redness of the breast
• the affected breast feels hot and sore
• severe breast pain
• cracked nipples (that may have led to the infection)
• fever and chills
• general flu-like symptoms

The risk of mastitis increases after difficult labor because the immune response tend to lower.

Inflammation in the breast may lead to the formation of an abscess in the mammary gland. Moreover, pus can be mixed with breast milk which makes it impossible to breastfeed. Mastitis can lead to sepsis and lethal outcome if not treated properly and in time.

When is a nursing mom at risk of developing mastitis?

1. First couple of weeks after birth
2. Damaged (cracked) nipples
3. Skipped breastfeeding sessions
4. Engorgement
5. Clogged milk ducts
6. Wearing a tight fitting bra
7. Never changing breastfeeding position
8. Stress, lack of sleep and exaustion (everything that leads to low immunity)

How to know if you have mastitis?

Mastitis is usually diagnosed clinically after the examine at the doctor’s office and the ultrasound of the breast. Mastitis is usually treated with antibiotics (because it is a bacterial infection). Some antibiotics are compatible with breastfeeding, so if your doctor allows you to breastfeed your baby, don’t be afraid and continue breastfeeding. If you need to stop breastfeeding while taking antibiotics, don’t forget to pump every 3-4 hours to support lactation and prevent severe drops in milk supply.

In some cases when the infection persists even after the treatment, your doctor may ask you for a sample of breast milk to identify the bacteria that is causing the inflammation. The doctor will then give you the best possible medications for treating mastitis.

How is mastitis treated?

If you were diagnosed with mastitis on the early stages of its development, you will highly likely be prescribed with antibiotics and painkillers, such as ibuprofen or acetaminophen.

Advanced stage of the desease with breast abscess (the collection of pus in a mammary glands) are treated surgically by either a needle (guided by the ultrasound) or surgery for draining the pus. Only after the abscess is taken care of, the doctor will prescribe antibiotics for further treatment of the inflammation.

How do I know if I have a plugged milk duct or mastitis?

KellyMom has a great article giving the detailed information on everything you need to know about plugged milk ducts and mastitis and how to tell the difference between one and the other.

7. Nipple Vasospasm

Vasospasm (Raynaud syndrome) is a narrowing of smaller arteries that supply blood to your breast, limiting blood circulation and causing the feeling of numbness and pain in the affected area.

The syndrome was first described by Jack Newman, a pediatrician from Canada. He suggested that the burning pain after breastfeeding is associated with a spasm of blood vessels. It occurs due to a rapid temperature change when the baby releases the nipple from the mouth. The nipple changes its color from beige to white. Due to the vasospasm, the access of blood is blocked, which may cause some pain after the feeding. The pain or discomforts may also occur between the nursing sessions.

If a nursing mom suffers from vasospasm, she should consult a doctor and be examined for autoimmune diseases, as the  vasospasm can develop as a result of having some autoimmne disorders.

Symptoms of nipple vasospasm

1. Burning and itchinh sensations in the nipple area that are often felt after breastfeeding or during a short period of time between the feeding sessions
2. White nipples. The color of the nipple is changed to whitish or blueish because the flow of blood is temporarily blocked due to the vasospasm
3. Episodes of deep breast pain that feel like sudden stabbing

Causes of nipple vasospasm

1. The primarly cause is considered to be poor latch
2. Exposure to cold temperatures
3. Second-hand smoking
4. Nipple damage
5. Autoimmune diseases, like Lupus, rheumatoid arthritis, and hypothyroidism
6. Emotional stress and exhaustion

How to treat nipple vasospasm? (Tips from Dr. Jack Newman)

Jack Newman has a protocol for treating vasospasm which can be found in his book Dr. Jack Newman’s Guide to Breastfeeding.

Dr. Newman recommends:

• All Purpose Nipple Ointment, a topical cream with antibacterial, antifungal and anti-inflammatory ingredients that will  help with sore nipples.
• Nipple massage with warm olive oil for instant relieve from the burning sensations during vasospasm.
• Treat deep breast pain for Mammary Constriction Syndrome.

Other recommendations to treat vasospasm:

• keep your breast warm, cover it immediately after the feeding
• apply dry heat after breastfeeding
• do not drink strong tea or coffee as they can cause spasms of blood vessels
• avoid nicotine and passive smoking
• avoid oral contraceptives with estrogen as they are linked with vasospasm
• make a breast massage to relieve the vasospasm
• dietary supplementation with Magnesium, Calcium, Vitamin B complex and fish oil may be helpful.

Tips For Preventing Breast Pain While Breastfeeding

In order to avoid breast pain, soreness or discomforts while breastfeeding, every nursing mother needs to know about preventive measures, as well as to respond promptly in case some unpleasant sensations occur.

How to prevent breast pain while breastfeeding

1. Breastfeed on demand. This will ensure an adequate milk supply and prevent engorgement and clogged milk ducts.
2. Correct the poor latch. The key to effective trouble-free breastfeeding is how your baby latches on. If any breastfeeding problem occurs, usually, the first thing to check is the right latch.
3. If you need to pump, make sure to use the right technique.
   1. Take a hot shower or apply a dry warm cloth to your breast before you pump
   2. Drink hot fluids 10 minutes before pumping
   3. Massage your breast with oil (coconut or olive) starting from the top coming down to the nipple using cirle motions
   4. When you start pumping, imagine how your baby is sucking your breast or take your baby’s photo and look at it while you pump. This simple trick will help you produce oxytocine, the hormone responsible for breast milk evacuation out of the nipple.
4. Practise proper breast hygiene. There’s no need to wash your breast before every nursing session. Taking a shower once a day is pretty much it. You may also apply some coconut oil or organic nipple balm in order to avoid nipple damage.
5. Use a nipple cream or bepanthen during the first couple of weeks of breastfeeding after birth to prevent cracked nipples and further infection.
6. Choose a good fitting bra that is comfortable for you to wear around the clock. Opt for maternity collections.
7. Use warm compress before every feeding if you noticed a clogged milk duct. Bend over and shake your breast a little to relieve pain and allow a better drainage for breast milk. The best position for breastfeeding would be hanging over your baby when his chin is pointed to the affected area with the clog.
8. Sleep on your side or back (not on your belly).
9. Keep your breast warm and safe from injuries.
10. If you feel excrusiation pain while breastfeeding, call you health care provider and schedule an appointment. In some cases it is better to stop breastfeeding for a couple of days until the symptoms get better and the pain becomes durable or goes away completely. Anyway, this is for your doctor to decide whether you should temporarily stop breastfeeding or not.

Breast feeding should bring pleasure and joy to both the mother and the baby. If something in this process goes wrong, a nursing mom starts feeling some discomforts and pain. It is important to find out the cause of breast pain while breastfeeding in time, and to eliminate the reasons as soon as possible. In case of acute or prolonged pain you should consult a doctor.