Breastfeeding pain: What causes it and how to treat it?

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  • Breastfeeding pain is extremely common among new mothers – however, this can often indicate that something is wrong, so should not be discarded as a ‘normal’ reaction if the pain persists for a lengthy period of time.

    There are many reasons why your breasts may be painful during or after nursing – the most common reason is a poor latch, but whichever reason it is, you should never be put off asking for help.

    ‘It is very common for women to experience breastfeeding pain, especially first-time mothers. It is normal for your body to take a few days when first starting to breastfeed to adjust and in that time, you may feel discomfort or pain,’ says Miss Eleni Mavrides, Consultant in Obstetrics and Gynaecology at The Portland Hospital.

    ‘This is usually because your breasts will over-produce milk at the beginning. You can help prevent this through massaging your breasts regularly, letting your baby finish the feeds and making sure your baby is attaching to the breast properly during feeding. Using over-the-counter medication such as paracetamol will also help you manage the pain if you are in need of pain relief.’

    So what are some of the most common reasons for breastfeeding pain?

    Breastfeeding pain: Problems with the latch?

    If your baby is poorly attached to your breast during a feed, your nipple may become pinched between your baby’s tongue and the roof of their mouth (the hard palate).

    This will make your nipples sore, and, before long, cause them to crack and bleed, which makes breastfeeding uncomfortable, even painful.

    When your baby is effectively attached, your nipple rests comfortably against the soft palate at the back of their mouth and can make a huge difference in comfort for you.

    ‘When your breasts over-produce milk, the baby may struggle to cope and can find it hard to latch on properly,’ Eleni said. ‘To help prevent this from happening, I would advise mothers to change the position of the baby frequently when breastfeeding.’

    One position to try involves putting your baby tummy-down on your body with their head near your breast. This is also a great position to try and get your baby to self-latch as they bob their head and move towards the breast with minimal help from mum, usually resulting in a pain-free latch.

    Don’t keep trying on your own if it still hurts — find a lactation consultant or visit your doctor or midwife.

    breastfeeding pain

    Breastfeeding pain: Breast engorgement

    If your breasts feel hard, tight and painful, it’s usually a sign that they are overly full, which can be quite typical for new mums as they adjust to the arrival of milk.

    An engorged breast can also make latching difficult, meaning it is harder for your baby to drain your milk, and more painful for you.

    To help ease the discomfort of engorgement, especially if your baby is yet to latch properly, you could try expressing some breast milk by hand.

    ‘If it’s painful when breastfeeding try to avoid using nipple shields,’ advises pharmacist Daniel Brash. ‘They can restrict the amount of milk the baby is able to get, which can lead to the breasts becoming more engorged and sore.’

    You could also try the age old method of placing chilled cabbage leaves in your bra after feeding or expressing, as the cooling effect on your breast can help to reduce the pain and swelling. Wearing a well-fitting bra designed for breastfeeding, so it doesn’t restrict your breasts, could also benefit you.

    Your midwife, health visitor or a breastfeeding specialist should also be able to help you deal with engorged breasts, or any other breastfeeding pain or concerns.

    Breastfeeding pain: Tongue Tie

    If your baby is suffering from tongue tie, it can make latching onto your breast correctly impossible. A tongue tie means your baby can’t lift its tongue up or stick it out so is unable to cup the breast as needed to help extract milk, which means a lot of pain for mum as the tongue can rub against the end of nipple, causing it to crack.

    ‘Ask your midwife or health visitor to check for tongue tie. Many cases are picked up while still in hospital but some are more difficult to detect,’ pharmacist Daniel advises.

    A doctor will be able to snip the thin flap of skin on the baby’s tongue so it is able to move more freely. This will make breastfeeding more effective and less painful.

    If you are worried about tongue tie consult your midwife, health visitor or a breastfeeding specialist.

    Breastfeeding pain: Blocked ducts

    If you’re making breast milk faster than it’s getting expressed, or it isn’t drained properly during a feed, it can get backed up in the ducts – the narrow tubes, which carry the milk to your nipple.

    When this happens, the tissue around the duct may become swollen and inflamed and press on the duct, causing a blockage, which can feel like a small, tender lump in your breast.

    ‘This needs relieving as soon as possible, and your baby may be able to help,’ advises NHS Choices. ‘If possible, place them with their chin pointing towards the lump so they can feed from that part of the breast.’

    You should try to feed your baby frequently from the affected breast or gently massage the lump towards your nipple while your baby feeds.

    Breastfeeding pain: Mastitis

    Mastitis is an inflammation in the breast tissues and can occur if a blocked duct is not relieved. The inflammation may quickly become an infection if not treated, which means that bacteria can grow in the milk.

    Mastitis can make you feel very unwell with flu-like symptoms. Your breast will also have a hot, red, very tender area and if left untreated could become a breast abscess.

    ‘If your breasts feel inflamed, red, hot, tender or lumpy, and you feel unwell with flu-like symptoms such as fever, chills and tiredness, make sure you ask your doctor or midwife for help straight away,’ advised Eleni.

    ‘You may be experiencing a localised infection (mastitis) and it is really important to treat it before it turns into a breast abscess. Mastitis can usually be treated easily through antibiotics however, if it does lead to a painful collection of pus (breast abscess), it may need to be drained surgically,’ she added.

    It’s important to keep feeding your baby from the affected breast. Although this may be painful and miserable for you, it will make the mastitis worse if you stop feeding from your affected breast.

    If you are no better within 12-24 hours, or if you feel worse, contact your GP. You may need antibiotics, which will be fine to take while breastfeeding.

    Breastfeeding pain: Breast abscess

    If mastitis becomes infected and is not treated it can lead to a breast abscess, which is a very painful, swollen, pus-filled lump inside the breast. You can also get a breast abscess due to prolonged periods of breast engorgement.

    A breast abscess needs immediate treatment and can be drained by your doctor.

    It is important to keep breastfeeding as this keeps the breast well drained. If it is too painful to breastfeed directly then try pumping or hand expressing.

    The La Leche League Great Britain, who ‘provide mother to mother support for all breastfeeding mums’, say: ‘You can continue to breastfeed from both breasts. If the affected breast is too painful or the incision is close to your nipple you may need to hand-express for a day or two. Keeping your milk flowing will help your breast heal.’

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