Dr. Daniella Perri Blog
Postpartum Health & Wellness
Dr. Daniella Perri Blog
Postpartum Health & Wellness
Pain during breastfeeding is not okay, yet it is a common symptom felt, especially in first-time moms. The important factor is differentiating between self-limiting sensitivity (discomfort that goes away) and pain associated with each and every feed.
As a first-time mom, breastfeeding can bring a whole host of new sensations. A tiny baby tugging at your nipple doesn’t feel like nothing, yet it shouldn’t feel painful. In the early days of breastfeeding your newborn, you may feel this discomfort, but it generally subsides as baby latches and you both find your rhythm and routine.
This is why breastfeeding support is so crucial. Not knowing that this discomfort will subside or, worse, that there is significant pain at each feed is the leading cause of early weaning!
Furthermore, pain is amplified by common psychosocial events such as sleep deprivation, anxiety, feeling alone, inadequate or frustrated, and having no support. So, in reality, pain is a combination of both physical stimuli and psychosocial factors.
Mechanical trauma from an improper latch is the leading cause of nipple pain. When your baby has a shallow latch, the nipple rubs against the hard palate at the roof of the baby’s mouth. This leads to nipple compression and results in the commonly known lipstick-shaped nipples.
A shallow latch and the high vacuum a baby creates within their mouths cause a lot of friction between the nipple and the roof of the mouth. Nipple tissue damage, cracks, bleeding, and, of course, pain are the result.
So what can you do to prevent nipple trauma?
Recent evidence suggests that the laid-back breastfeeding position significantly reduces nipple trauma and pain and is conducive to a healthy latch.
On the outside, it may look like your baby is latching well to your nipple. However, on the inside of their mouth, their tongue mechanics might prove otherwise. A tongue tie is when the baby has a short lingual frenulum (piece of tissue that tethers the tongue to the lower jaw).
A tongue tie may be the reason why your baby cannot latch properly, which leads to sharp, biting pain and therefore, nipple trauma. One solution is a frenotomy—a surgical procedure where the frenulum is cut to allow more tongue movement.
Recent research has concluded that a frenotomy may cause short-term reduction in a mother’s nipple pain. However, there isn’t enough evidence to show that this procedure will result in longer-term breastfeeding success. The point is that surgery is not your first go-to.
This is where a lactation consultant and breastfeeding assessments are essential. Implementing a multidisciplinary approach can help to remove all roadblocks to breastfeeding so that you can reduce pain and aim for continued breastfeeding success.
Sometimes, there are things happening in the breast and nipple tissues that cause breastfeeding to hurt. Below are some physical signs that something may not be right within your own breasts.
Nipple dermatoses: eczema, psoriasis, and Raynaud’s syndrome—vasospasms in the breast that cause lightning bolt pain—can contribute to breast pain, making it difficult to enjoy breastfeeding.
Infective mastitis: inflammation in the breast tissue with a bacterial infection can cause significant pain. Knowing systemic symptoms such as fever, chills, and overall malaise (in addition to localized breast pain) can help to identify if an infection is present.
Milk blebs: these are tiny blisters at the end of the nipple—also known as hyperkeratosis of the ductal opening—can cause nipple pain. The best way to resolve these is to continue to breastfeed. Never pop them!
If your goal is to experience a healthy long-term breastfeeding journey, then resolution of breastfeeding pain should be a priority. At the onset of pain, a trip or phone consult to your healthcare practitioner is the first step.
Identifying associated symptoms such as breast redness, tenderness, lumps, cracks in the nipple, and even stress and anxiety can help to diagnose underlying conditions that cause breast pain. Infective mastitis and postpartum anxiety can amplify breastfeeding pain.
We also can’t forget that breastfeeding is a dyad relationship between mom and baby. Assessments of latch, oral development, and breastfeeding positions can also help to improve the breastfeeding experience.
Wherever you’re at in your journey, there is support. Your naturopathic doctor, midwife, or lactation consultant can lead you on the path to having a breastfeeding success story. Don’t suffer in silence. Get help sooner rather than later!