The birth of a child brings about a range of overwhelming emotions in new mothers: joy, excitement, apprehension and anxiety. It also comes with the responsibility of breastfeeding in the first hour of birth since the mother’s milk is the best nutrition for a newborn, and breastfeeding is supposed to be a satisfying experience for mother and baby.
But new mothers can feel breast pain and nipple soreness when they initiate breastfeeding. Although this pain can be resolved by doctors and nurses to make sure the mother can feed her newborn without soreness and pain, it is advisable to seek medical help if the pain persists beyond the first two to three weeks after birth, to rule out a serious condition.
In a study published in the International Journal of Breastfeeding, researchers advised against the use of anti-fungal medication as the first line of treatment for breast pain since there is not enough evidence to prove that candidiasis (a fungal infection often cited as causing breast pain) was the reason for deep breast pain during and after breastfeeding. They also suggested that in a hospital setting, healthcare providers and lactation consultants should focus on identifying problems related to breastfeeding technique and support the mother in positioning and correct attachment of the baby to the breast to avoid breast pain.
Common causes for breastfeeding pain
- Incorrect position and latching technique: While it is natural for mothers to feel a twinge of breast pain when they first put their newborn to breast, the most common causes for breastfeeding pain during and after nursing are incorrect breastfeeding position and latching technique.
Dr Ravneet Joshi, a pediatrician who practises at Manipal Hospitals, Bengaluru, tells Happiest Health that during breastfeeding the baby latches on in such way that the tongue overlaps the lower jaw, so the baby is holding the breast between the upper jaw and the tongue, and not the lower jaw.
“Most of the areola (dark skin around the nipple) will be in the baby’s mouth,” says Dr Joshi, who is also an international board-certified lactation consultant (IBCLC). “This way, the mother will not feel pain while feeding. If the mother is experiencing pain, she needs to change the baby’s position for a better latch. The oxytocin reflex that helps milk flow can also cause a sharp pain in the breast initially, but that is temporary.”
The mother must be counselled by healthcare providers on the right position to feed the baby. The different positions include
- lying down
- cradle (a sitting position with the baby’s head supported by the mother’s forearm on the same side as the feeding breast) and
- sitting with a pillow on the lap for support.
- Engorgement: When there’s an increase in the mother’s milk supply in the first week of birth, the breasts become really full and engorged, which leads to pain and soreness in the breasts. If a baby is feeding well and there is regular drainage of the milk, engorgement will not occur. If the breast is engorged even after nursing, the mother should express the residual milk with the hands or use a breast pump. If not addressed, this problem can cause blocked ducts or infection in the breasts.
- Flat or inverted nipples: When the nipples are turned inside (inverted) or flat, the baby may not be able to latch on. “Even though size of the breast and nipples have no bearing on breastfeeding, it is advisable to let the baby latch on within the first hour of birth because there is an active interest to feed and the breast is also soft,” says Dr Joshi. “If the nipples are severely inverted, a nipple shield or syringe technique may be used as a temporary measure till the baby latches on to the breast directly.”
- Blocked milk duct: Milk flows to the nipples through the milk ducts inside the breast and sometimes these ducts may get blocked and cause pain. Gently massaging the breasts and placing a hot compress before feeding can unclog the ducts.
- Mastitis/Bacterial or fungal infection: Inflammation of the breast accompanied by redness, pain and hard areas in the breast is called mastitis. Emptying the milk from the breast regularly and avoiding engorgement can prevent mastitis. Infections should be reported to the doctor for appropriate treatment with medications.
How to prevent breast pain
“In order to prevent pain during breastfeeding, the mother must check that her nipples are firm enough by using her fingers or a cold compress to stimulate the breast, and use the correct position to support feeding,” says Roopshree Jaiswal, a lactation consultant at Motherhood Hospitals, Indore, Madhya Pradesh. “She must also ensure the baby latches on to the areola and not on the nipple.”
Takeaways
Some tips for new mothers to prevent breast pain:
- Learn proper positioning and latching technique before leaving the hospital.
- Breastfeed the newborn every two to three hours and on demand.
- Gently put a finger on the side of the baby’s mouth to stop the feed or change position. Do not pull the nipple.
- Apply mother’s milk to sore nipples and let it dry, to help them heal.
- For mastitis or engorged breasts, gently massage the area and place a washcloth dipped in warm water over the breasts just before breastfeeding. After the feed is over, place a cold compress over the nipples.
- Sit in a comfortable area and be relaxed for nursing. Use pillows for support.
- Consult the doctor promptly for severe breast pain or possible infection.
