Does breastfeeding hurt? If it is painful, is something wrong?
Saturday, January 2, 2010 I received a reader question from Shannon @zchamu and Jacquelyn @jacquelyncyr based on a discussion they were having with some other women on a message board.
On the message board Jacquelyn said:
So I've been thinking about this for the last few weeks and, man, the whole painless breastfeeding frenzy thing seems like a bit of a scam. I don't get why there is so much literature out there talking about how easy and painless it is, and how if it's not both of these things, there is probably something wrong. That does NOT seem right to me - I wonder if it's actually that way for most people? ... WHY does the entire "industry" or whatever you want to call it not acknowledge this fact? Why don't people talk about the fact that it can be excruciating to have a previously innocent rack suddenly suckled within an inch of its life? It makes a gal feel like she's not doing it right or something is the matter or it wasn't meant to be or whatever.
After reading the discussion where Jacquelyn and many others recounted the pain they experienced while breastfeeding (some felt pain only initially and for others it lasted much longer), Shannon e-mailed me. She recapped the question and discussion and then said:
So I wanted to throw this over to you. What about the statement that "it shouldn't hurt" and what do you think it means, first of all (does it mean it should NEVER hurt? Does it mean that after an adjustment period it shouldn't hurt? Does it split hairs between "discomfort" and "pain"?) And second of all, what do you think it does to women trying to breastfeed to hear that statement, when they are obviously struggling with it? It would definitely be discouraging, to hear that it shouldn't hurt if you're "doing it right", kwim?
I know it's kind of a big question, hee, but I think it's an important one and i thought you'd be the perfect person to spring a discussion about it.
What do you think?
What do I think? I think it is complicated! But I'll give it a go...
Is pain normal?
The number of women who experience no pain or discomfort at all while breastfeeding is probably equivalent to the number of women who have experienced orgasm during birth. It is rare enough that everyone has heard the horror stories. It is rare enough that people tend not to believe women who say they experienced no pain at all.
So pain while breastfeeding is frequent, but it is normal? According to breastfeeding expert Dr. Jack Newman:
Though some tenderness during the first few days is relatively common, this should be a temporary situation that lasts only a few days and should never be so bad that the mother dreads nursing. Any pain that is more than mild is abnormal and is almost always due to the baby latching on poorly.
Moms who have been there and done that will tell you that you just need some time to let your nipples toughen up. Lactation consultants and other breastfeeding experts will tell you there is no such thing as letting your nipples "toughen up" and that if it hurts, something is wrong and you need to fix it ASAP.
The reality, I think, is somewhere between the two. I don't think that you necessarily need time for your nipples to toughen up, but I do think that any new breastfeeding pair needs some time to get used to each other and to get their technique down right. I do think it is worth asking why it hurts and what you can do to manage and eliminate the pain.
Challenge 1: Finding out why it is painful
Other than the mild tenderness that Jack Newman spoke of above, the pain that moms experience when breastfeeding does usually have a cause. According to Kelly Bonyata, IBCLC, from kellymom.com in her article on Healing Tips for Nipple Cracks or Abrasions:
Keep in mind that one of the most important factors in healing is to correct the source of the problem.
In her post Does Breastfeeding Hurt? Well...Yes and No. Mostly no., Sara from Custom-Made Milk explains that:
The majority of women will feel some pain in the first few weeks of breastfeeding while her baby learns to latch, while her nipples accustom themselves to being stretched out, and while her baby’s mouth grows larger.
Some people may call this toughening up the nipples, but I think it is more mom learning to breastfeed and baby learning to nurse. As with anything in life, some people are quick learners and others are not. I think that is why it takes longer for some women to get over the pain than others. But as with learning disorders that go undetected, nursing problems that go undetected will not go away on their own. But if you find out the source of the problem, you can usually do something about it.
If a mom is experiencing acute pain or even mild pain that doesn't seem to be getting better as time passes, it is worth a call to La Leche League, a visit to a lactation consultant, and/or posting a message on a reputable message board. The most common problem is issues with the latch, which is tricky because it is not always easy to fix. I know what a good latch looks like and feels like, but it took me forever to get to that point. When my son was not able to latch on, and then later when he was able to but his latch was painful, I wished desperately that I could borrow someone else's baby to nurse for a moment so that I would know what a good latch felt like. I longed to pass my baby over to the lactation consultant and have her try to nurse him and tell me if his latch felt right. I didn't know if it was my technique, my baby's technique, my breasts, or his mouth that was the source of the problem. It was frustrating, humiliating, and painful.
Beyond the latch, there are numerous other problems that can interfere with learning to breastfeed. Just like a tight Achilles tendon may prevent some children from being able to walk properly, a tight frenulum (tongue tie) can prevent some babies from being able to latch properly and can cause pain for their mothers. A mom may be doing everything right, but that won't make a difference unless the problem is dealt with.
Other things that can cause pain or discomfort include thrush, a bite, milk blister, plugged ducts and mastitis, breastfeeding after breast surgery, being pregnant, ovulating, and more.
Whatever the problem is, figuring out the source is the most important thing you can do to prevent future pain.
Challenge 2: Stopping the pain
Finding out the source of the pain is the first step, but not the last. There are many things that you can do to relieve the pain and heal cracked or sore nipples. If your nipples are damaged, it will keep hurting even if everything else is right.
A lot of women probably aren't aware of even half of the things you can do to heal your nipples and deal with the pain. A lot of women probably suffer more than they need to. A lot of women probably give up when they didn't need to. Sara from Custom-Made Milk lists some of the things that a lactation consultant should have mentioned to help a mom to heal her nipples and prevent further damage in her post Does Breastfeeding Hurt? Well...Yes and No. Mostly no:
If you haven’t heard of soothies, if you haven’t heard of loosening up your breast tissue before nursing, if you haven’t heard of weaning the baby back onto the breast, if you haven’t heard of breast shields, if you haven’t heard of lanolin, if you haven’t heard of vitamin E, if you haven’t heard of air-drying, if you haven’t heard about the proper types of bra to wear and about breast shells that can keep your bra from chafing your nipples.. If you didn’t learn how to properly wash your breasts (hint: no soap or hot water!) if you didn’t learn different latch-on techniques and if you didn’t learn about rotating breastfeeding positions to minimize repeated irritation to certain areas of the breast…. If you didn’t learn about nursing up-hill to correct hyper-supply that makes your baby bite down.. If you didn’t learn about nipple confusion…If you didn’t learn about personal fit shields, if you didn’t learn about the symptoms of tongue tied babies, if you didn’t learn about proper fit of breast pump flanges…
Nipple pain is one of the most common things that women face. It is one of the most common reasons for early weaning. There are so many tools out there to help moms get through the difficulties. Yet so many do not make it through.
How can breastfeeding experts help moms who are experiencing pain?
There are a lot of negative attitudes about breastfeeding in society. So I understand breastfeeding advocates wanting to improve the image of breastfeeding and I wholly support that goal. I understand when they want to make it sound easy and wonderful, but I don't think that is entirely the right approach. I say that because I also know how difficult breastfeeding can be and how much it can hurt (read our story). I also know how vulnerable moms can be when they are experiencing breastfeeding difficulties and I know that saying "you must be doing something wrong" is not going to give them confidence or make them feel supported.
On the heels of a fascinating survey about breastfeeding in Today's Parent, Katrina Onstad wrote an article called Breastfeeding Sucks in Chatelaine. She wrote:
...what enrages me about my breastfeeding experience (it went terribly both times) isn't that my freedom was so surprisingly and severely curtailed, or that I was once forced to nurse in a filthy bathroom stall, or even the pain itself, it's that I was negated by the very people who claimed me as one of their own. I think that if someone, somewhere in the pro-breastfeeding camp had said: "It will get better. You are doing the best you can," then maybe those first months wouldn't have been such a crazy-making vacillation between profound joy and utter agony.
As a moderator on a breastfeeding support board, I learned how carefully you need to choose your words sometimes. I learned that answering a question by a mom on the Newborn board is not just about answering her question, it is also a therapy session and a cheerleading session.
It is hard though. Hard to find the balance between being truthful and not scaring moms away from breastfeeding (because it does get better). Hard to juggle dealing with real breastfeeding problems that moms are facing and remembering to tell them they are doing a great job. Hard to figure out what is par for the course and what needs immediate attention.
Image credit: sean dreilinger on flickr.
Reader Comments (88)
For me, it never did hurt. I was of the mindset, when I first got pregnant, that I wouldn't even breastfeed, as I thought it would be KILLER painful, etc. Then I had my baby, and I tried it... and it was, to me, VERY easy, and pain-free. Of course, that rare time my son would bite too hard, or something, but overall, it was not painful at all. Not at all... same with my second baby, too. I'm thankful for this, as I'm sure it made the experience that much more pleasant for me!
Exactly PhdinParenting.
Breastfeeding was acutely painful for me for the first 6 weeks, much greater pain than the unmedicated contractions I had right up to transition. It was finding the Jack Newman videos online that lowered my pain AND the constant support of girlfriends who said that it would get easier that made breastfeeding feasible . The girlfriends said that it would be worth it, that after two months I would be soooooo pleased I'd been able to do this, and they were right on all counts, but up until that point it sucked. There was no intimate moment between mother and child just searing pain. After about that 6-8 week period it became a breeze. I was able to nurse up to 13 months at which point my one breast (the other had a load of scar tissue, a story for another day) stopped producing. I was fortunate enough to have a work place that allowed me to work part-time upon my return for 6 months and had an office that I could pump in. If I'd had to return at 6 weeks to full time work and/or to a place without an appropriate I wouldn't have been able to make it.
For me, I never had any pain, well thats not true, my Birdie is 8 months old and now that she has 8 teeth sometimes we have an accident but for the most part it was pain free. I attribute most of that to the unmedicated birth. We had the benefit of having no interruption in our breastfeeding relationship mainly because she was born at home and was put to the breast within moments of being born. Of course everyone's experiences are different but when i compare my experience to what others have had, I've been lucky.
One of the most helpful things for me was when I was late into my pregnancy and had joined and mom and baby group, and all the mothers told me how the first 2 months of breastfeeding are pretty much horrible, but that it gets so much better after that. They gave me the advice to promise to stick with it for 2 months (at least), and only after that even consider giving up if it still was going very badly.
Then when D was born and I was experiencing pain, I rounded up the emails of every mom I knew who breastfed and asked them what their experience had been, if it had hurt for them, for how long, and asking them for advice. Almost every one replied about how it hurt for them for the first 2-3 months, then got much easier after that. And that is basically how it went for us, as well.
I was SO glad to have that information, because it prepared me. It let me know that it was NORMAL to have some pain. Of course, I did whatever I could to check his latch and try to make sure we didn't have any problems that were causing the pain, and Jack Newman's videos were priceless in helping me at that time. But, I really do think that for most breastfeeding moms it is going to hurt for a few weeks at least, and that is not necessarily a sign of a problem. If all I'd ever heard was that breastfeeding only hurt when you're "doing it wrong", I don't know if I would have kept at it.
I love Dr Newman, his videos were lifesavers for me, but honestly I have a very hard time listening to a man who has never breastfed tell me it should only feel a little sore for a few days. It seems very strange to me to really think that such a delicate and sensitive part of your body would suddenly be sucked on 8-12 times a day and that this sudden change wouldn't cause some serious discomfort for a while.
I had one medicated birth and one unmedicated birth. With the medicated one, due to tongue tie, my son didin't even latch on until he was 7.5 weeks old. I then had an excruciating 7.5 weeks of teaching him to latch until we were nursing fairly pain free. With the unmedicated one, I had my daughter on my breast within a minute or two of her being born. Despite knowing WAY more than the average person about good latches and bad latches, it took a few weeks until we were nursing without any discomfort at all.
I teach breastfeeding classes to pregnant mothers, and I drastically changed my approach to the pain question after I had my own baby. My training taught me that breastfeeding shouldn't hurt beyond slight soreness upon latch-on for the first 2 weeks. Now, my basic message to moms is that it will probably hurt, and not to give up because it's going to get better. I'd rather risk scaring them a little (besides, so many of them have heard horror stories of bleeding, blistered nipples, which I assure them is NOT normal), then have them think something is wrong with them and give up when they feel pain.
I think you're right on in your assessment that the resolution of the initial discomfort is not the nipples "toughening up", but the mother and baby learning and improving in their technique. In a normal breastfeeding relationship, when the baby is latched on properly but still causing soreness, this can often happen without any intervention, through the practice that comes with nursing on-demand and the baby's mouth opening wider as she grows.
Thanks for bringing up a good topic.
"Hard to figure out what is par for the course and what needs immediate attention."
Yes! This, in fact, is why I think that breastfeeding advocates say that it shouldn't hurt. It's not because we're trying to be rah-rah, breastfeeding is happy and fun and fabulous. It's because in many, many cases moms encounter breastfeeding problems in the early days of nursing, especially with their first baby. And you don't want to say, "Pain is normal," and then have a mom try to soldier through a problem and become discouraged and / or experience worse issues like severe damage or mastitis.
I have seen the opposite situation happen, when a mom is experiencing serious pain and a breastfeeding counsellor tells them that their latch 'looks fine'. And that's equally problematic, or maybe even more so. Because then a mom still isn't getting help, may experience greater problems, and is being discounted. It's a very tricky line to walk, and it's very difficult to evaluate 'normal tenderness' and 'situation that needs attention', especially when, as you say, the mother herself has no experience on which to draw.
I had medically induced labor and a c-section but my baby was brought to me in the recovery room and allowed to latch. I was lucky the hospital nurses understood the importance of the first few minutes when the baby is aware and eager. I did not have any pain at any point in my experience then or in the months to come. However Mary and PhD seems to connect a difference in levels of pain with breastfeeding after a medicated birth. Mary implies her lack of pain is from no medication and PhD connects medicated birth with tongue tie, though not explicitly, and it's attendant issues. My experience doesn't bear this out. I think PhD' original points in her post do a good job articulting the probable reasons for pain. Not to say a medicated birth causes no problems, however, my understanding was that those were primarily supply issues or a lack of education on the part of caregivers that babies should still be given to moms and allowed to feed in the immediate window of oppourtunuty following birth.
I had pain and purple bruised nipples for over 9 weeks. I went to the hospital LCs and I never saw them look in my baby's mouth not once. They had me feed her and weighed her and told me it was my fault for not latching her correctly. Fed up at 9 weeks I hired a different LC and it turned out she was tongue tied and having that fixed made a HUGE difference in the feeling of feeding and the appearance of my nipples. To add insult to injury I discovered in my baby's medical records that the hospital LC wrote "baby is fine, anxious mom" and sent that to my pedi! That's great to label me. I threw that paper out when I switched pedis and I wonder if we shouldn't have been worried if I was a non-anxious mom and didn't care enough about my baby to try as hard as I did?
No pain like that is not normal but even the support system that is supposed be in place fails. If I am ever able to have another child I won't let the hospital LCs into my room.
My experience with my youngest was somewhat unique. After my milk came in and the initial "hye, there's a little guy on my nipples" pain went away, I was only having pain on one side. It also happened to be the side he favored. We tried different holds. We tried different things.
And then? He screamed at me, mouth open wide, and we saw it. Severe tongue tie! We're still not sure why I didn't have pain on the other side other than the fact that he didn't favor that side.
As soon as his severe tongue tie was fixed? No more pain. From that very first latch in the doctor's office. And never, ever again. ...until that first time he bit me. HA! Good times.
Well I have nursed 6 children now and I can say that ALL of them learned diffrerently #1 well nursing her at first hurt for a couple of days at the beginning.
#2 Well Im not sure what happened But I stopped nursing at about 6 weeks I believe it was due to forceful letdown/Bad Latch I dont think I enjoyed that B'feeding relationship very much or I wouldnt' have give up so early, I remember being in a lot of pain nursing him too..
#3 Well she loved nursing and still for the first week while we were getting to know one another nursing did hurt a little at the beginning, in fact I remember having a painful latch for a while, but she hated my forceful letdown and then refused to nurse after it.. (I switched to pumping for 6 months)
#4 He loved Nursing and while it hurt a little at the beginning, when we got to know one another and the way he latches one and me showing how to do it properly we nused till he was 11 months old.
#5 Loved Nursing from the start, The smallest amount of pain while he learned to open up wide but then it was great I nursed him till he was 14 months old.
Now Im on the the last LO, he is now 9 months old, and right from the start it was just a pinch I tried to get him to latch on correctly and open up wide hew really never got it, instead he taught me, that he could latch him way and always took in a little and slid so he was latched, I thought it was cool how he showed me how to do it this time, and I never had any pain nursing him!
I had the usual initial pain, but it only lasted two weeks or so, and then i was cruising until my son was about three months old. One of my nipples became cracked, but the pain was so bad I thought it was thrush. i went to the doctor, and she confirmed there was no thrush, and that my nipple was cracked. She didn't offer an y advice on healing sore/cracked nipples, and she was a self-proclaimed nursing mom. She just shrugged and said, "Well you might just have to nurse on one side only". But I refused to, so i endured the pain and did my own research. It took a long time for that nipple to heal, and it's still proned to cracking.
i'm very stubborn, and i was determined to make this relationship work. But I can understand why some women give up and switch to formula instead. That being said, there is enough info out there for every mother to do her own research and become well-educated and informed about common breastfeeding challenges and solutions.
Mine always hurt for the first few weeks after birth. I thought I'd skip the pain after my third was born since I was still nursing a 2yo at the time, but nope. My nipples still got sore and as usual, we all got thrush- which is another thing I got after each birth. Then sometimes just out of the blue, once or twice a year, I will have fresh pain in one or both breasts, but it only lasts a couple of weeks. I try to make sure everyone is latching properly (still nursing the 4yo and now 2yo). Honestly, worse than the pain ever got, are the feelings of creepiness that sometimes come over me.
For the first few weeks I would say my nipples ached a little. I've since associated that sensation with just times when my nipples are suddenly used a lot more: I've felt the same thing when she's sick, having a growth spurt, or teething because she's suddenly nursing more than usual. It's actually the same ache I get while nursing while pregnant too.
But other than that, I had no pain at the beginning: no blisters, no bleeding nipples, no bad latch. In fact, DD was so picky about her latch, that she would unlatch if it wasn't perfect. I've never actually had a bad latch with her except for teething times. I'm grateful that she was so picky because it meant my transition to breastfeeding was fairly easy as far as affect on my nipples- but it did make for some hard nights when she would reject every latch for 45 minutes because it wasn't "perfect" for her.
Bev:
I wasn't trying to connect the tongue tie with the medicated birth. Sorry if it came across that way. Tongue tie is hereditary.
That said, moms who have a natural unmedicated birth do tend to (a) have their milk come in more quickly (than for example with a c-section) and (b) have a more alert baby. Both of those help to facilitate breastfeeding in the early days.
After a really poor start, nipple shields, a baby who wouldn't suck ANYTHING, flat nipples, extreme engorgement, and a too forceful letdown I welcomed the pain of "just" a bad latch. I thought "hey if it hurts at least he's nursing!" But then it really hurt. Oh it hurt. It hurt like fire burning my nipples and flames shooting down my breasts and a letdown that made me scream and cry in pain. After watching every video and reading every book and having an LC show me the proper latch time after time after time I finally self-diagnosed thrush. A few vinegar washes, some gentian violet and one prescription for All-Purpose Nipple Ointment later and I went from dreading every feeding to the happy contented nursing mother I dreamed of being. It took four very long months and more work than I could have imagined but five months later we're still going strong.
I think LC's and lactivists are sometimes so focused on latch that they forget pain can be caused by (as you mention in one quick sentence above) "... thrush, a bite, milk blister, plugged ducts and mastitis, breastfeeding after breast surgery, being pregnant, ovulating, and more." It's the "and more" that can hurt a breastfeeding relationship the most. There's a mom in my breastfeeding support group who has Raynaud's Phenomenon (http://www.asklenore.info/breastfeeding/raynaud.html) and nursing was excruciating for weeks until she happened to read an article that mentioned it and brought it up to our LC herself and started vitamin B supplements. Pain is not always someone's fault, it's not always due to a mother doing something wrong, it's not always avoidable and it's never a good thing. I think if we were more open with new mothers about the MANY things that might make breastfeeding hurt they could decrease the length and severity of breastfeeding pain immensely.
"Pain is not always someone’s fault, it’s not always due to a mother doing something wrong, it’s not always avoidable and it’s never a good thing. I think if we were more open with new mothers about the MANY things that might make breastfeeding hurt they could decrease the length and severity of breastfeeding pain immensely."
Yes. Yes. Yes. Exactly!
another awesome post annie. this topic is so important and complex. i have spent the last 3.5 years nursing my two kids and i agree with what you said about each nursing dyad having to learn their way to a comfortable and pain free relationship. i went through this process (and it was surprisingly different) with each child (even though i was still nursing the bean when chickpea was born - at home unmedicated).
i have spent so much time educating myself on breastfeeding (especially thanks to the kellymom site and forums) and so i have ended up providing peer support to a lot of new mom's i know. i always tell them that it will hurt some, that they need to be prepared for some discomfort, and also that pain is an indication that something is wrong and they need to have an IBCLC lined up (have the number on hand and know the cost and when/how that person is available) before they even give birth. honestly, i think getting knowledgeable support right from the start is the most important thing. and, that leads us to the incredibly sad state of affairs -- how difficult it is for most mom's to get knowledgeable support.
sorry to drone on. just wanted to be here cheering on an important conversation.
This is such an important point that is not discussed enough! My personal breastfeeding experience was very painful and confusing. We had a host of issues starting with a very sleepy child because of an emergency cesarean, milk not coming in for 8 days, a poor latch as she was very stubbornly trying to suck with her tongue on the roof of her mouth, a long battle with thrush, cracked bleeding nipples, and a forceful letdown reflex causing her much distress. I struggled with trying to figure out what was going on and how to fix it and cried along side her as she tried to nurse as the pain was so crippling for me. I was told my a very well meaning midwife that it shouldn't hurt and obviously the latch was wrong - but I could not figure out how to fix it and her comments just made me feel more lost and discouraged. I wondered what I was doing wrong and felt like a failure.
Luckily I was stubborn and did not give up, doing lots of research and hiring a LC who was very reassuring and helpful. Now we are going into our 8th month of nursing and it is very successful finally after 4 months of stress and pain.
I agree that there are MANY things that might make breastfeeding hurt and make a first breastfeeding experience frustrating and make new moms give up, I have heard this over and over with friends of mine. It is SO important that REALISTIC and helpful information is available to women on all aspects of breastfeeding so that when problems occur there is support and information readily available (hard sometimes for a new sleep deprived mom to do internet/book research). It is a fine line between being positive and advocating for BF and being frank and honest about the hard things one can go through. The main message should be that it is worth it, there is help, and it will get better! I think there is definitely some room for improvement on our support system for BF - ideally it should start with our pregnancy care providers.
I'm wondering if some pain being the norm when beginning breastfeeding isn't somewhat of a cultural phenomenon. If we surveyed people living where breastfeeding is the cultural norm, would we find that they made similar statements? Also, I believe some of the pain is due to babies being placed on the breast either by the mother or a health care provider. Babies will often achieve a better latch when they are placed skin to skin with the mother and allowed to initial normal pre-feeding behaviors such as rooting and searching for the breast. When an infant approaches the breast with the nipple near his nose, he is more likely to place his lower lip well below the nipple, which is more comfortable for the mother and more effective for baby. Just a thought. I wasn't aware of the baby led latch with my first baby, who was also tongue tied. With my second baby, I wasn't successful using the baby led latch because my baby was too upset by being separated from me briefly, immediately after birth. So this is purely theoretical for me, but wondering...
I had pain at first, but it turns out that one of my nipples was flat and it was painful until it was sort of drawn out and more regular. Also, his latch wasn't perfect and that caused some pain until I got that corrected.
By the time he was 1 month, I think I was nursing pain-free -- if not sooner.
We recently had some problems again. He was a late teether. At 12 months, he now has 4 teeth. As his teeth were coming in (unevenly, ugh) his latch wasn't quite right. Also, I was nursing him in his car seat with me sitting next to him and our latch wasn't very good. That resulted in him biting me (not on purpose) and it hurt while that healed.
I have breastfed 5 babies now. One for her entire life and the other 4 into toddlerhood. I don't have to learn how to do it, I know what I am doing. Yet for those first few days, every time, it hurts like crazy until my milk comes in. Nothing wrong with my latch. Babies have fantastic suction. I have to grit my teeth together and try to get through it, reminding myself that it will get easier.
Thankfully, I had seen my mum go through the same when I was 16 and she had my baby brother. I heard her discuss with her new mommy friends at the breastfeeding class, how their nipples were cracked and bleeding. And then I watched them get to the easier stage and enjoy a long lasting, fulfilling nursing relationship with their babies.
Had I not seen that, perhaps I would have felt something was wrong when I went through those painful few days the first time around. Perhaps I would have given up. I've been told many times if it hurts, I must be doing something wrong. I just don't believe that. The first few days it just hurts. Like crazy. And then the milk comes in and it starts to get better.
I've had other times where it has hurt. When my toddler is teething or thinks it's funny to start sucking a weird way. Not fun. But patience is the key and remembering it will pass and improve.
My mum felt pain every time her milk let down. Women experience let down in varying ways. Mum 's was always sore. For a few seconds. It can all be normal. I think it's important that women know if there is pain it doesn't necessarily mean something is wrong. And it doesn't mean it will be that way forever.
Before I learned to breastfeed my bub, the only thing (And I do mean ONLY) I had heard about breastfeeding was that it was easy and natural and didn't hurt. This was mostly from my mother who had a very easy time of it from all reports :)
I experienced pain till around 12 weeks, for various reasons, but initially in hospital before my milk came in, the latch was fine and everything was dandy, but it HURT. I have very sensitive nipples normally, and she had one heck of a suck, and it DOES take some getting used to (in my experience of course). It wasn't 'uncomfortable', it made me want to crawl out of my skin. Later on, the sources of pain were different and able to be identified, but in the beginning I think it's reasonable to allow for some amount of discomfort OR pain while your breast is getting used to it.
I will also note that I felt like a failure every time someone told me that I must be 'doing it wrong' because it wasn't meant to hurt. How frustrating for a poor mother in pain!
this issue ticked me off during the early part of my breastfeeding journey. everything i had read said that pain meant something was wrong, so i was going nuts for the first 9 weeks of my son's life trying to figure out wth was causing so much pain. not thrush. not mastitis. not positioning. not his latch. not tongue-tie. everything looked a-okay when i had LLL leaders and lactation consultants check everything out, but it still hurt like the devil. i had a completely natural birth, and my kid was both posterior and 9 lbs 4 oz, and i will insist until the day i die that breastfeeding was much, much, much more painful and difficult than labor was (and labor wasn't easy!). eventually, it just stopped hurting. i don't know why. but by golly in the beginning i would sit there and just sob as my son nursed. i absolutely dreaded nursing and wanted to quit sooooo bad.
i have had friends ask me if breastfeeding was hard, or if it hurt, and i have been honest with them. but i am quick to tell them that even though it can be very, very difficult in the beginning, it is worth it. i know many women who have regretted having to switch to the bottle, for whatever reason, but i don't know anyone who persevered through breastfeeding challenges who regrets it.
i am also quick to tell friends that for some mamas breastfeeding is just easy. no problems, no pain. for most there is an adjustment period that can be trying and yes, a little painful. and for some breastfeeding is just awful in the beginning. i was one for whom breastfeeding was terrible. but we got through it (with many, many tears and lots of support), and i am so thankful.
I've BFed 3 kids. W/ my first latch-on was excruciating, curl-your-toes pain for about 2 weeks. I muscled through it and we went on. I've always considered that I've had an incredibly easy time BFing, and that pain was normal as your nipples got used to being USED. I watched my cousin BF her 3 kids. She said she had sensitive nipples and even with the 3rd kid her nipples bled immediately and she had a lot of pain (LC involved in the process). So I though pain was pretty normal and surmountable and didn't freak.
After my 2nd came I had that same pain in one breast and figured out immediately that he was latching lazily on that breast. We addressed it in the hospital and it was remedied immediately. I always wonder now if #1's pain was poor latch or not but the big lesson I learned is that YOU can be the most proficient BFer ever but your baby is learning.
I think the distinction here needs to be that nipple pain is normal - as in lots of women experience it, no need to freak, no need to blame yourself, no need to wean but that nipple pain
*could* be a sign of poor latch, etc, so if it's a problem for you feel free to change things around/seek help. I really hate the "nipple pain is a sign that you're doing something wrong" advice. Nipple pain is COMMON...and not a cause to freak :)
I had cracked/grazed nipples with my little one. I have a high pain threshold but it made breastfeeding mind numbingly excrutiating and I would dread feeding her and with a newborn that's every couple of hours and somtimes (it seems) continuously! Sometimes I would be up in the middle of the night, feeding her and balling my eyes out with the pain.
It really helped me when the lactation consultant let me know that because of the damage the inital latch would hurt - but that if it was still hurting after 10-20 seconds then it wasn't a good latch and I should try again. Not only did this help me get the hang of proper attachment, it also allowed my nipples a chance to heal and gave me an idea of what breastfeeding could be like once everything was back to normal. It took my nipples a couple of weeks to clear up and after that there was never any pain.
Thank you for posting this. No one ever told me just how much breastfeeding would hurt. I just heard 'it takes 2 weeks, just give it 2 weeks!' But when two weeks passed, 3 weeks, 4 weeks, 5 weeks etc.. and there was still excruciating pain, I definitely wanted to give up. What I didn't know was that aside from tongue tie, poor latch, my stress levels and anxiety, I also had thrush. So thank you for mentioning thrush. I had no idea I had it when I first got it, and spent weeks in agonizing pain that could have been avoided. I didn't even know it existed until I Googled the symptoms I was feeling. I wish someone had told me ahead of time what the causes of pain could be, aside from poor latch.
I have four children who have all nursed to some degree. With my first son, I'd taken the breastfeeding class at the hospital, bought books, and committed to doing it, but after hearing "if it hurts, you're doing it wrong" so many times and being a less confident, new mother, having a screaming, hungry baby with severe jaundice and a pediatrician who told us to supplement, the pain of totally raw nipples that felt like they were being suckled by razor-sharp kitten teeth was enough to push me over the edge. (I also had flat nipples and wasn't confident I could even do it.) I met with a lactation consultant but only nursed him until his first pediatrician appointment at two or three days, at which point I switched to pumping exclusively. The pumping only lasted six weeks before I gave up completely. I am a hippie/natural type, so this engendered (still does) some serious mother guilt.
With my second baby, I think confidence/experience made all the difference. I committed to breastfeeding, no matter what, before she was born. I bought a good pump (had had to run out and rent one in a rush with baby #1), researched pain, etc. The level of pain was the same with her... still had the flat nipples made raw/bloody the first few days... still shook and cried when she nursed and dreaded every nursing session... but I was so much more comfortable with every other aspect of mothering that I stuck it out successfully. She continued nursing until 2 yrs 9 mos (just once at night at that point), until I finally weaned her myself because I was entering my third trimester with #3, and my nipples were KILLING.
My 3rd baby started nursing just three months after #2 stopped. I had hope that this would make it easier or less painful, but no such luck. Even though my daughter had drawn my nipples out, and I was very experienced at breastfeeding at that point, I still got the same raw, bloody nipples... although the pain might not have been QUITE as bad... I'm not sure... He nursed until he weaned himself at 17 months.
Number 4 was pretty much the same as #3. He's still going at almost 8 months. :)
Oh my gosh. I just realized I've nursed for about 59 months of my life. Woot!
I was recently at a brunch with two new moms and another who was expecting her first in a few months. Having nursed my son until he was 2.5 I was the veteran breastfeeding mom in the group. Both new moms were telling the expenctant mom to expect pain and that no one told them to. I can't remember but I think someone told me to expect it because when my son was born I wasn't shocked at all.
I remember being tender but not pain, I was often in tears however because latching on took forever with my sleepy newborn. He had to be stripped naked, and prodded to stay awake to nurse. That ut me in tears for a few weeks and like developing a good latch, we had a steep learning curve in our relationship, then it was smooth sailing for more than 2 years.
I experienced an insane amount of pain when I started to breastfeed my daughter -- without the encouragement of my best friend, my partner and my FABULOUS nipple cream, I'd never have made it through.
I breastfed 3 babies now, 44 months total. Not as long as some, but I am still pretty proud of it. I had a horrible time with my first and would not have made it without a lot of resolve to at least make it until 6 months. I still had a hard time with #2 (less so) and #33. I actually hurt my jaw because I was clenching my teeth so bad due to the pain with #3.
I think, I know, that there is so much about breastfeeding that isn't known by the people who are supposed to help you. We don't know as much because many of us didn't grow up around it, surrounded by it. I wish that we could be better prepared for the good and the bad and know when there is a problem and then what to do to fix it...
I don't think it is so difficult to distinguish between normal pain and abnormal pain in breastfeeding - based on how long it lasts, how the nipples look, whether the nipples hurt when you are not breastfeeding, etc. I had some abnormal pain at the beginning from a bad latch. I also had some normal pain because my nipples were inverted so it took a little while for them to change shape to be more breastfeeding-friendly. But I breastfed for about 30 months and only experienced pain for the first of those months, so overall I think of breastfeeding as a non-painful experience.
I don't know if this is a useful comparison or not, but the first few times I had sex it hurt. This was normal, and once my muscles down there stretched out it stopped hurting. Some friends of mine experienced pain for a lot longer, and needed to know what was not normal and required medical help. Our society has managed to convey the message that sex is wonderful and feels great but also that sex hurts at the beginning, without those two things being contradictory. Why can't we do the same for breastfeeding?
Amber, that's it exactly. The single most helpful piece of information I had when starting breastfeeding was the knowledge that it shouldn't hurt if things were going right, because it meant that, when it did hurt, I knew something had to be *wrong*, and kept asking different people for help despite initially being brushed off with 'the latch looks fine'. Eventually, I found the midwife who could tell me that it was because of my son's tongue tie. While this didn't actually help much in practical terms because of the lack of facilities in our area for getting a tongue tie cut, it did help a lot to have identified a definite problem and at least know what it was I had to be fixing. If I'd been left thinking that the pain was just par for the course, it would have been unbelievably discouraging, and much more likely to make me give up.
I don't know why people are so ready to interpret "It shouldn't hurt" as "If it does, you must be doing something wrong." I interpreted it as meaning that there had to be a problem somewhere, but I certainly never interpreted it as meaning that the problem must be my fault. It seems like a sad comment on the insecurity of many new mothers that they're so ready to hear that (usually non-existent) subtext. What to do about that and how to stop the statement being taken in that way, I don't know.
"I don’t know why people are so ready to interpret “It shouldn’t hurt” as “If it does, you must be doing something wrong.” I interpreted it as meaning that there had to be a problem somewhere, but I certainly never interpreted it as meaning that the problem must be my fault. It seems like a sad comment on the insecurity of many new mothers that they’re so ready to hear that (usually non-existent) subtext. What to do about that and how to stop the statement being taken in that way, I don’t know."
I just wanted to comment on this; that the reason I personally took the statement that way, was because it was delivered that way. Several times, I was told directly that if it hurt it was because I was doing something wrong. In those exact words.
Hurts like mad with #1. Fixed latch problem. Then no more pain. #2 came along and all was easy peasy, but still looking back it IS very difficult to latch a NEW newborn. I guess it is a combination of the mom's experience (ie knowing how it should feel, what problems to look for, having the confidence that baby will be well-fed, etc) and the baby's natural instincts/predisposition that really determines the steepness of the learning curve.
FWIW, my milk came in significantly later with my unmedicated birth than with my medicated. My 2nd child was easier to nurse, though, and I credit this in part to the fact I was also nursing a toddler at the time. I'm anticipating a bit more difficulty in the early weeks this time around. My oldest had the upper lip equivalent of a tongue tie and it was many weeks before he grew enough that his lip could flange out a bit. I kept nursing from sheer stubbornness, but it really was excruciating.
This is such a great piece. It echoes the need for support at many levels of nursing. Each experience can be different, each baby (same mother) can be different. In my case with my son I had very little to no pain, and with my daughter there was some pain/tenderness at first but I was prepared for it and pushed through. I wasn't prepared for the 'lazy' nursing of my son who took what seemed like forever (vs the quickness of my daughter) or the complete rejection by each baby of one breast etc. The more support, information and honest/truthful answers we can give new mothers, hopefully the more that breastfeeding can continue.
Well done.
Having heard the horror stories, I was very nervous about nursing. It turned out that breastfeeding never hurt for me beyond very minor discomfort in the first couple of days, and the only "problem" I had was a bit of diffuculty latching when my milk first came in on day 5. I actually resent a little all the warnings and horror stories. To me, it's kind of like all the stories that are circulated about how awful and painful childbirth is. It only serves to scare women, instead of educate them.
I also wonder if pain during nursing has anything to do with individual's nipple sensitivity. Mine are not sensitive at all. My husband and go to town on them and it doesn't do a thing for me. So, I think that may be part of the reason I never had pain. Now if I could just get my daughter to stop pinching with my breast with her hand while she nurses...
With my first, the first 3 weeks hurt my nipples as I got used to nursing, then we were fine. With my second, for the entire ten months, letdown felt like bullets shooting through my nipples. I persevered, but if I was to do it over again, I would not have succumb to peer pressure and I would have quit nursing within the first month. Nursing was a terrible experience for me the 2nd time around. He fed every hour, fussed and scratched and fought me the entire time. I think we both hated it. And now that I know better, I have no shame in saying I probably wouldn't have nursed a third baby had we decided to expand our family further. No way.
I had sore and cracked nipples the first time around and I assumed it was par for the course that it should hurt. I soldiered through without complaining because I wanted breastfeeding to go so well. Finally my midwife noticed I was wincing and took a look at my nipples and helped me understand that while it is normal to have some sensitivity it shouldn't hurt that badly. But everyone told me my daughter had a great latch and she was indeed getting enough milk so I assumed everything was fine and would have continued on that way for who knows how long. What was missing for me was the fact that I had a right to be comfortable. Even if a baby's latch is good it doesn't mean both parties are necessarily doing fine.
I had to keep reminding myself of this very important fact. What might work for one baby just might not work for the other baby. I found myself comparing the ease of breastfeeding (once we got the hang of it) with the difficulties with my new baby girl. They BOTH responded very differently. I wrote more about this on my blog to avoid blogging in your comment box. Thank you for giving us a forum to discuss this! :)
I've always thought there might be a connection between nipple sensitivity and breastfeeding pain (I mean, duh, it seems obvious that there would be, right?). I have very sensitive nipples and found breastfeeding painful with both my kids, though the pain went away quicker the second time around (after a few weeks rather than a few months). But for those first few weeks both times, it felt like my nipples were being rubbed down with broken glass. I took ibuprofen around the clock to take the edge off, and cursed when I needed to, and just got through it because I knew it would get better. And it did. In retrospect, I think that latch was part of it, but both my babies were small and had teeny little mouths, and I just had to wait for their mouths to grow so they could latch better. But, I was always mystified by the idea that pain was abnormal, because it seemed quite foreseeable to me, especially the first time when my nipples were sore and sensitive throughout the pregnancy.
Thank you so much for this. I most definitely heard and read the words, "If it hurts, you're doing something wrong" when I was preparing for breastfeeding. Now I tell new and expectant moms that it might hurt, and they should research and follow up to be sure it's not a sign of something going on (thrush etc), but that you can't expect a delicate part of your body to be sucked on and kept wet for 8 hours a day without a little bit of pain or discomfort. The good news is that it does pass.
Pain should always be listened to. Yes, there is something wrong, if you are in pain.
The bit that's not in here, is the notion that _you may never find out why_. Babies' mouths grow, and the muscles build, and the entire head reshapes in the first few days and weeks of breastfeeding. A slight tongue tie may stretch, and Mum may learn to latch in a way that compensates, the baby gets better at it. Some women can be in agony and bang, they wake up the next day, and it's gone. Others soldier on being told 'get on with it'.
Pain is. No one can tell you you are not in pain. No one can say if you hurt more, or less, than they do. If a Mum is saying she is in pain - SHE IS IN PAIN. And that has to be dealt with.
It shouldn't hurt. But just as we've lost the skills that make it a physical skill we know how to do as we've seen it from our own childhood a gazillion times... we've lost the knack of comforting and supporting women in getting it right.
Birth practices impact on breastfeeding. You bet your bottom dollar a whole slew of interventions, will make breastfeeding harder, and more painful, for an entire host of sound physiological reasons - because the baby does the breastfeeding, not the Mum! And there isn't the expertise available to compensate for that, and allow the Mum and baby to find each other. Why it is hurting can be an incredible complex web of inter-connecting reasons, and all we can do is say that, offer support, and help Mums over come it.
Every Mum needs told, whilst pregnant, that it may hurt - but it shouldn't - that they need help and support if it does, and more importantly, learning to breastfeed is a spectrum. Some mothers have joy and happy magic tears in seconds, some have horror and pain and bleeding nipples - and most fall in between. Just about everyone will need to learn to juggle, and that breastfeeding is harder for the first 2 months than bottle feeding. But it gets easier, and less work, and bottle feeding stays at a high work level for at least a year. Whilst most women get into their stride and get on with breastfeeding in a few weeks, with the right support. But happy magic tears is not guaranteed - it's how you feed the baby, and thats' the baseline.
We all know some things are hard. Riding a bike is hard, passing an exam is hard, changing a life habit is hard - but there is an expectation of support and progress, no matter how much you battle on. Sadly, this is not the experience of breastfeeding mothers, who usually find "Don't worry, give up, it doesn't make a difference." within hours of birth!
Par for the course is the same for breastfeeding as it is for everything else: prepare for the worst, hope for the best, and something in-between will usually happen. :-)
And preparing for breastfeeding means someone telling you you may have what looks like a great latch, and no obvious problems, but it could still hurt like hell. So you should know if there is a cranio-sacral therapist in their area, who can help see if the baby's head plates are not re-aligning properly and therefore nursing hurts as the baby's mouth action isn't right! :-) http://www.kellymom.com/bf/concerns/baby/cst.html
And someone to stand there and say YOU CAN DO THIS! Just like they would if they'd taken all the skin off their knees falling off their new bike. :-)
Well said - I agree, it all comes down to needing support and information
I had a hard time getting the first two babies' latches right in the beginning, we worked through it by visiting the local breastfeeding drop-ins, but the blisters and cracked nipples were painful (both babies born with an epidural), once the latch was fixed, no more pain! Second two babies (born at home, unmedicated) latched beautifully from day one. With all of them, I have always felt a strong letdown sensation, I wouldn't call it painful, perhaps I felt discomfort at times.... Breastfeeding during ovulation was painful, and breastfeeding during pregnancy was painful (nursed until same point throughout all my pregnancies, until 20 weeks).
susie ;)
Annie,
A good post with lots of great comments. Just a small note from one of those breastfeeding advocates/helpers out there. In 46 comments (so far), almost every one describes a different sort of pain. When a mama calls me, I run through the most probable causes for the pain (and latch is definitely the first contender) and there are many times when I just can't figure out why she's in pain. It's not because I feel "if it hurts, you're doing it wrong" but that I'm only one person, who is not experiencing the pain, and I cannot know every reason why a mama might hurt. I do my best to go through the top problems, adjusting what we can to help. Sometimes, I just have to say, "I'm sorry, I'm not sure" and lead her to another person who might be able to help. I generally tell most mamas who contact me that bf can be challenging for about 6 weeks, and that the three month mark is the life-changer, where it all seems to get easier.
All that being said, if one person, one LC, one IBCLC doesn't help, call another. Contact a local La Leche league, hear from mamas who may have been down that road.
I disagree that breastfeeding "shouldn't" hurt. I wish it didn't, but I think for some babies/nipples, for whatever reason, it will. It's nothing to do with the G#@damned latch. I successfully and lengthily breastfed two babies, and it always hurt for the first 2-3 weeks. A lot. Some breastfeeding advocates are as bad as the formula companies with their propaganda mongering. I would have been a lot happier if I'd been forewarned that breastfeeding might hurt, even if everything was being done right.
I've watched a zillion latch videos, read all the literature, and by my second child certainly knew what a proper latch on looked like. After the first month or so, I could lay/sit in any position you like, with any degree of positioning, and it wouldn't hurt at all. There's just a lot of dogma and a lot of people repeating the b'feeding orthodoxy line on this. Especially if (hurray) one didn't have pain - it's so easy to assume that others were doing something wrong, or not adequately consulting LLL. More likely there are biological differences involved in either mother or baby or both. I have very fair, sensitive skin. Perhaps that's something to do with it. Also, I think the natural easing of the pain after several weeks sometimes coincides with someone seeing a lactation consultant, so they conclude that the LC "saved" them, rather than nature just having taken its course.
[...] issues I hadn’t dealt with before including a pinched nerve in one leg. Then there are the usual breastfeeding issues that make me wince and cry. And hating how I look in clothes, which makes me cry, etc, etc. I just [...]
Breastfeeding definitely hurt for the first 2-3 weeks...both times. But it was oh-so-worth-it.
Here's a link to a post about my experience: http://metropolitanmama.net/2009/03/what-is-best-is-not-always-easy/.