Why do I hurt when I breastfeed?
A text by Andréane Loubier, birth attendant
I'm going to get straight to the point, the sentence: "It's normal that it hurts at first, your breasts will get used to it..." is probably THE sentence that makes my hair stand on end the most.
It's common for new mothers to talk about pain during feedings, but just because it's FREQUENT doesn't mean it's NORMAL.
There are many causes of breastfeeding pain, whether nipple pain or breast pain, and in this article I will address those that I encounter most frequently in my practice.
Latching on to the breast
How your baby takes the breast into his or her mouth is very important. Baby must, first of all, open his mouth wide to take a “big bite”. If he only grabs your nipple, it will probably hurt. Also, your nipple should be pointed towards his soft palate. A nipple in the middle of the mouth will definitely cause pain. I think this is the adjustment I make most often when I support mothers.
Breast latch should also be asymmetrical. That is, baby's chin should be pressed into your breast, but his nose should be clear. His legs and body should therefore be closer to you than his head.
Some women can simply bring their baby close to their breast and boom! He opens his mouth and latches on. On the other hand, it is very common to have to help the baby, especially in the early stages. Offering him a bite while holding your breast may be necessary to give him a helping hand. You will therefore have to support your breast and offer it to your baby “on the good side”. What does that mean? Well, imagine yourself eating a hamburger, but trying to take a bite by holding it vertically! So! It's a bit the same thing for your baby. You need to present it at the right angle to facilitate “the big bite” I was talking about earlier.
Also, remember to leave room so your baby's mouth can be wide open. If your fingers are too close to your nipple, you may prevent your baby from taking his or her mouthful because there won't be enough space to do so.
Your baby must first of all feel safe and his body must be well supported on you and/or relaxed on your nursing pillow. This includes his head, because we want to prevent his neck from having to force it to maintain the position. His stomach should also be facing you, so baby should be lying on his side, ears – shoulders – hips aligned, to prevent him from having to turn his head to drink.
Additionally, your baby must be at the right height. You should not push or pull your breast to get it to his mouth, because as soon as you release it, it will return to its place naturally and it may move enough to disturb your baby's latch. Finally, when your baby opens his mouth well, you must quickly approach him, avoiding pushing behind his head. Approach his whole body at the same time.
Baby's neck/shoulders/clavicle tensions
All babies would benefit from an appointment with an osteopath or chiropractor, who specializes in perinatal care, to make sure everything is okay with their body. That said, it is even more important to consult this type of professional if you notice that your mini human is drinking very well from one breast, but is having difficulty latching well on the other. This could be caused by tensions that prevent it from positioning itself well.
While waiting to see a professional who will assess what is happening with your baby, you can try another breastfeeding position that would reduce tension on this potentially painful or uncomfortable side.
Very engorged breasts
The first time a woman experiences engorgement, more or less intense, is during the milk flow, that is to say a few days after birth. Sometimes it is more discreet and the mother does not feel any discomfort. Often, the breasts become hard and hot and sometimes the baby has difficulty holding on to them because they are so full and distended. You can then gently massage your breasts so that a little milk flows out, before offering it to baby.
You can also extract a little with your breast pump. A warm compress to soften the tissue a little might also be helpful.
If you notice that you have bumps and/or redness, it may be blocked milk ducts. If these bumps and/or redness are combined with chills, fever and a feeling of having the flu, these are symptoms that resemble mastitis and if this is the case, you may need to go consult a doctor promptly to take antibiotics. Either way, it can go from “a little painful” to “excessively painful” in a short time and it is important not to delay seeking help.
Thrush, vasospasm and other problems
Of course, there are many other possibilities, such as thrush, a fungal infection that rarely bothers baby, but can cause severe pain for mom. Vasospasm which can occur in the nipples, which occurs after the end of feeding, once the baby has let go of the breast, and which is often described as a burning sensation.
I have to stop here, but I strongly suggest, again, that you consult a breastfeeding specialist at the slightest pain, because I repeat: it is not normal.
So yes, breastfeeding is a natural gesture. Yes, for most mothers and babies, these become sweet and precious moments. But for it to become so, and as quickly as possible, being prepared, being well informed AND well supported are, and will always remain, essential.
Happy breastfeeding…without pain!