Top 5 Painful Breastfeeding Challenges

Breastfeeding comes with a lot of different challenges that each mom and baby pair will navigate together. For some, achieving a proper latch can take weeks of practice. For others, milk production and transfer can require some extra help. While challenges in breastfeeding are totally normal and to be expected, one thing breastfeeding should NOT be is painful. In fact, pain while breastfeeding is almost always a sign that something isn’t quite right. Some causes of pain while breastfeeding are easily fixed and relief is almost instant. Other causes are more serious and require the support of a lactation consultant or Dr to help get them resolved.

Here are the top 5 reasons breastfeeding might be causing pain and how to address them.

1. Sore Nipples

This was something that, as a new mom, I wrote off as “normal”. It almost stands to reason that with a baby sucking on your breasts all day, sore nipples could be expected! While that logic might be sound, breastfeeding itself shouldn’t be the cause of sore nipples.   

Typically, nipples might feel sore at the very beginning of a feed (they are sensitive after all) and subside throughout the feed, although sometimes the pain is constant and remains even after the feed is finished.

Babys latch is almost always the culprit in nipple soreness. Making sure baby has a nice, deep latch and is cleared of any tongue or lip ties can be the difference between pain and comfort while breastfeeding. For sensitive nipples in the first few days/weeks while you and your baby are learning this new skill, nipple creams like Lanolin applied to the nipple can ease discomfort and help make feedings less uncomfortable.

Candida (yeast) can also be a cause for sore nipples, in which case you should seek treatment for the infection from an IBCLC or Dr.

As always, if nipple pain/ soreness isn’t resolving or you have any concerns, don’t be afraid to reach out for support from a Lactation Consultant or Dr! Their resources and support can make all the difference for your breastfeeding experience.

2. Engorgement

 Contrary to popular belief, engorgement is not just “fullness” of the breast. You may have heard stories or seen pictures of nursing moms soaking through their shirts after a couple hours away from their nursing baby. While super uncomfortable (and BEYOND embarrassing), fullness and leaking is not the same as engorgement. Engorgement is a combination of edema (fluid retention) in the breast tissue and “milk stasis” (milk not being removed easily). This causes breasts to become full, hard, and even painful.

Engorgement is most common in the early days while breastfeeding is being established. Mothers who have been given IV fluids during their births are also more likely to experience engorgement as the excess fluids settle in the fatty tissue of the breasts. These excess fluids will dissipate on their own within a few days, unfortunately, they can create challenges with latching as newborns are unable to get a big enough mouthful at the breast, making engorgement worse.

Practical solutions for engorgement include applying heat to the breast before feeding, hand expressing some milk before feeding and reverse pressure softening to help baby be able to latch well and remove milk efficiently.

Download this How To Instruction Sheet for Reverse Pressure Softening

3. Blocked Ducts/ Blebs

 A result of poor milk transfer, a blocked duct is exactly what it sounds like. When a congealed milk blockage forms inside a milk duct, milk gets trapped behind it resulting in a painful lump inside the breast (where the blockage is) that gets smaller after feedings.  If the blockage occurs at the tip of a duct, it results in a “bleb” or “milk blister”.

Milk Blister

Blockages and blebs, while painful, usually resolve themselves within 24-48 hours. To help a blockage resolve, you can apply heat (warm cloth or bean bag), massage during feeds or even use vibration (interesting use for your electric toothbrush) to encourage it to dislodge. Continue feeding on the side with the blockage as it will help it to dislodge.

Important note about Blebs: It is NOT recommended to attempt to pop or pierce a bleb with a pin, even if it’s been “sterilized”. It is best to let it resolve on its own to avoid infection.

4. Mastitis

When bacteria (most commonly staph strains) enters the nipple through nipple damage (sore nipples) and travels into a blocked area the infection is called Mastitis. The infections causes a hot, hard lump to form in the breast accompanied by a high fever, general malaise, and even delirium. Mastitis symptoms can feel like the worst flu symptoms making it incredibly difficult to function as you normally would.

While uncomfortable, it is safe and even recommended to continue to nurse on the infected side, emptying the breast as best you can to avoid any new blockages. Not all mastitis infections require antibiotics and should resolve within 24-36 hours with rest, hydration, and adequate nutrition.

Ibuprofen and Acetaminophen can be taken for pain.

 If you suspect that you have mastitis, it never hurts to visit your Dr.

If your symptoms do not improve or gets worse after 24 hours, it’s important to see your Dr for treatment.

5. Abscess

On occasion, a blocked duct can become infected and sealed off. If this occurs, the lump behind the blockage will not get smaller after feedings. As with ANY lump in the breast, it’s important to talk to your Dr. An ultrasound of the lump will be done and antibiotics or drainage may be prescribed to treat an abscess.

Breastfeeding shouldn’t hurt!

Painful challenges in breastfeeding are one of the top reasons why a mother might decide to end her breastfeeding journey, whether she feels ready to or not. Breastfeeding should NOT be painful and being aware of these potential challenges, how to address them and knowing where/when to reach out for help can not only help improve comfort but the overall probability of breastfeeding success!

If you are struggling with pain while breastfeeding, Talk to a lactation consultant who can help you sort out what could be causing it!

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