“Tricky Nipples Pay my Bills”  – Val, Workin’ Moms (Netflix)

Yep, that’s my life too, because nipple pain is the number one reason that people come to me for help. It’s also one of the top 3 reasons why women stop breastfeeding before they wanted to. The families that I see nearly always tell me that others have said that breastfeeding does hurt in the beginning and they just need to get through it.

So what’s the truth?  Should breastfeeding hurt? Will it get better after a couple of weeks? Is it normal? Here’s the low down on nipple pain and breastfeeding:

What causes nipple pain?

It’s true that nipple pain is common in the early weeks of breastfeeding. It’s usually caused by a baby’s mouth being too shallow on the breast or nipple. When the nipple isn’t deep enough in the mouth it rubs on the hard part of the roof of their mouth (the hard palate) …ouch!  Sometimes the nipple is squeezed between the tongue and the hard palate which can cause mis-shaping and sometimes damage which may look like a cut or blister.

Some babies will use more of a chomping action when in a shallow latch position,  which can feel a bit like biting and may case damage or bruising type pain around the base or sides of the nipple.   In other cases a baby may just be sucking on the tip of the nipple which can be very sore!

Why is it so common?

In many Western societies we don’t see a lot of breastfeeding. In fact many women won’t see breastfeeding up close or in real life at all before having a go themselves. With all that we know about how our brains and our bodies learn a new skill, it’s hardly surprising that we don’t get it right straight away.

Painful nipples during feeding is a sign that the latch isn’t quite right at that moment. For many women, this will improve with time as they and their baby find their way with positioning and getting a deeper latch. For many this is an unconscious process. When we repeat a task often enough it starts to become automatic. Unconsciously, we are learning how to do it in the easiest, and least painful way.  Babies are also getting bigger and more alert and are working out how breastfeeding works best for them too.  For some, things will improve quickly, but for others this won’t be the case.

It’s also worth knowing that in a shallow latch position, many babies will not be able to get as much milk out of the breast than if they had a full mouth of breast. This can make feeds take longer or mean that your baby doesn’t get enough milk overall.

How do I stop it from hurting?

Many Mums will reach for the nipple ointments or shields and although these may help in the short term, they don’t address the actual latch issue itself.  Here’s 3 things that you can do to try and improve things first:

1 – Change position. Breastfeeding is not a one size fits all. We all have different shaped bodies, boobs and babies. Switch up you position and see if it helps. You could have a go at popping your baby under your arm at the side of you (rugby hold) or reclining with your baby laying on top of you (laid-back position). Try a few out….there are so many variations! You may need help at first especially if you have had a c-section. Make sure that whatever positions you try, that they are comfortable for your whole body. Being as relaxed as possible helps.

2 – Line up your nipple to our babies nose not their mouth. To take in full amount of breast, babies need to open up wide. We can encourage them to do this by aiming the nipple above their mouth and pulling them in close to us when they open wide. To do this you may need to move your baby’s body slightly. You can rub your nipple just below their nose to encourage them to open.  Visuals can work wonders when learning a new skill and I can recommend Global Health Media and their videos for a good visual of getting a deep latch. https://globalhealthmedia.org/portfolio-items/attaching-your-baby-at-the-breast/

3 – Seek some support. DO NOT WAIT. If you are dreading the next feed, if latching on is toe-curlingly painful and certainly if you have damage to your nipple, then get help immediately – even if someone has told you that the latch looks fine. Pain means that it isn’t right and often, just a few small adjustments will make all the difference.  Seek out your local breastfeeding group or find an IBCLC ( https://www.lcgb.org/find-an-ibclc/ ). If there’s something more complicated going on such as a tongue tie, then they will be able to sign post you on to the right service.

And a final word on breastfeeding pain in general, is that it isn’t always latch (although often it is). Things such as thrush, blocked ducts, vasospasm, mastitis and tension-related pain can also be common issues in breastfeeding, but as above, seek out support. Find your local breastfeeding group or specialist and don’t be afraid to ask for the help – it’s what we’re here for!