How can I avoid breast and nipple pain?
There are a number of reasons why your breasts and / or nipples can become uncomfortable whilst you are feeding, with the most common being sore nipples as you get breastfeeding established. It causes a great deal of anxiety for mothers, but once resolved feeding is usually plain sailing. So let’s talk about this first. Why do women get sore nipples in the first place?
A very common cause is poor latching
Nipples that do not stick out
Baby may have a poor sucking technique
Infection of the nipple e.g. candida or staph aureus
Baby may have a problem such as tongue tie
Inappropriate use of breastfeeding aids – breast pump, nipple shields and shells
A skin condition of your nipples e.g. dermatitis or psoriasis
By the time baby is 3 days old your nipples may simply be sore as a result of baby using its suck to try and mould and stretch your nipple into a teat shape. And if this happens 8-12 times a day then a little pain is to be expected. This kind of pain usually subsides within a minute of commencing a feed and there is no visible damage to your nipples. By day 6 the discomfort should resolve. This is often referred to as nipple stretch.
Poor latching technique
During pregnancy its a really good idea to read up about breastfeeding and in particular how to achieve a good feeding latch in the first few days after birth. If you are struggling to get it right or you are simply “not sure if it’s correct”, ask the midwife on the ward to observe your latch or assist you to achieve a good latch.
(How to get a good latch is covered in a separate topic)
Flat nipples
Every woman is unique in their body shape and appearance and not least when it comes to nipples. Nipples that are on the flat side or even inverted (go inwards instead of outwards) sometimes pose a few initial challenges when it comes to feeding – not always though. Whilst on the postnatal ward your hospital midwife or lactation consultant can give you tips that will help, such as how to shape the nipples outwards by touch and position or using a cold cloth on your nipples before feeds.
Infection of the nipples
Infected nipples will almost certainly cause discomfort, so its important that if your nipples are sore that any infection is diagnosed and managed appropriately. The more common infections are fungal e.g. candida and bacterial infections where staph aureus has occurred via a cracked nipple. Both can be treated managed quite easily once diagnosed.
Less commonly in the first few weeks women can suffer from dermatitis or psoriasis of the nipples, which can also be treated and breastfeeding continued with less discomfort.
Your baby’s sucking style
Many babies know how to suck and will do so very well with minimal assistance, however some have what is commonly called tongue-tie (ankyloglossia). This is when the band of tissue in the middle of the under surface of baby’s tongue is too short to achieve an effective latch. This can then causes sore nipples. Tongue-tie is present at birth, it has a familial tendency and is more common in boys than girls .The incidence is approximately 4% in healthy new babies.
A skilled Midwife, lactation consultant or paediatrician will be able to make a diagnosis of tongue-tie and direct you to someone who can easily snip the tight band of skin, which should then result in successful breastfeeding.
Breastfeeding aids
Breast pumps, nipple shields and breast shells can all be used to help ease the pain of sore nipples, but only with limited success, indeed If they are used incorrectly or inappropriately sore nipples can be made worse.
Finding the reason for sore nipples and then managing the problem is key to continued breastfeeding. If your nipples are painful you are more likely to reduce the time you spend feeding your baby and introduce formula milk to pacify a hungry baby.