How to deal with breastfeeding pain

For new mom Shawna McIntee, it wasn’t just the centrefold-worthy size and tenderness of her breasts that caused concern the day her milk came in—it was the unexpected pain she felt in her armpits, which were covered in agonizing welts. “I had milk backed up all the way under my arms,” says the Toronto mom. The pain was so intense that she had to walk around with her elbows in the air—for days. A lactation consultant assured her that the problem, though uncomfortable, was just a case of blocked milk ducts and could be solved with warm compresses. She was also advised to breastfeed frequently to help drain the excess milk.

A week later and the swelling was gone, but by then McIntee was coping with another painful problem: Her nipples were cracked, bleeding and sore. She discovered that her baby wasn’t latching properly. A poor latch is the No. 1 reason women experience pinching, burning pain and sore, cracked or bleeding nipples, particularly within the first few weeks, says Amanda Pendergast, a family doctor in St. John’s, NL. But a latch issue isn’t the only catalyst for soreness. Here are the four most common causes of breastfeeding pain and how to deal with them.

Latch issues

There are many techniques for finding a good latch, adds Holly Bowler, a registered nurse and certified lactation consultant at McMaster Family Health Team and maternity centre of Hamilton. Bowler recommends that women who are struggling seek help from a lactation consultant who can take them through the options. In the meantime, here are her top five guidelines for getting a good latch:

1. Choose a moment when the baby is calm and not distressed or crying. Skin-to-skin contact can help with this (and with increasing milk supply).
2. Cradle your baby in your arm with her body facing yours, supporting her back and neck. (Your baby’s neck should be in line with her ear, shoulder and hip.)
3. Line the baby’s nose up with your nipple. Holding your breast, use your nipple to tickle her upper lip to make her open her mouth.
4. Wait for her to open wide (like a big yawn). Then, with your hands behind her shoulders, quickly bring her towards you, so that she’ll get a big mouthful of your breast and the nipple will point upwards, toward the roof of her mouth.
5. Bring her body in closer to help deepen the latch.

Bowler says you’ll know the latch is good if your baby’s nose isn’t buried in your breast, you can hear an audible, rhythmic swallowing sound, and your nipple is a normal shape post-feeding (not a wedge shape, like a new lipstick).

Mastitis

Mastitis is a bacterial infection that inflames breast tissue and affects three to 10 percent of breastfeeding mothers. It causes swelling, skin redness and burning pain while nursing.  The infection can also cause flu-like symptoms, including fever, body aches and chills. Some women get a lump on their breasts that is tender to the touch, says Pendergast. The best treatment for mastitis is antibiotics, especially if the fever and pain has persisted beyond 24 hours, she says. Warm and cool compresses also help, as does pain medication (ibuprofen or acetaminophen). You can continue to breastfeed with mastitis, notes Pendergast.

Thrush

This common infection is caused by an overgrowth of yeast in the baby’s mouth, which then spreads to mom’s nipples, causing wince-inducing soreness. Women often complain of pain that feels like sharp needles going into the breast, says Pendergast. They might also have red, itchy nipples. (In rare cases, a vaginal yeast infection can be a symptom, but this is more likely if thrush develops in a newborn.) She says the easiest way to definitively diagnose thrush is to examine your baby first: Babies with thrush will have white, cottage-cheese-like specks in their mouths and may also have a dark-red diaper rash. To deal with the problem, both mom and baby need to be treated with antifungal medication, after which the infection should clear up within a few days.

Tongue-tie

Tongue-tie is a genetic condition in which a baby’s tongue movement is restricted by a strip of skin (called the frenulum) that anchors the tongue tightly to the floor of the mouth. It means a baby may struggle to pull the nipple into the correct place in the mouth, explains Bowler, which can lead to sore, cracked nipples for mom—and some babies may not get enough milk while nursing. Treatment varies: if all is well for both mom and baby, you don’t need to do anything about it, says Pendergast, but if nursing is painful (or if your baby isn’t gaining weight), then sometimes babies will undergo a frenotomy, a simple procedure in which the doctor snips the frenulum to release the tongue.

Read more: 7 surprising reasons breastfeeding is good for babies 5 common breastfeeding mistakes and how to avoid them