Painful breastfeeding - why does it hurt?

By Nadee Guy, Babiz

A painful breastfeeding experience, whether you are breastfeeding a newborn, an infant or a toddler, can be demoralising. It can even lead to thoughts about giving up your breastfeeding journey altogether.

If you are suffering with painful breastfeeding problems, it’s likely you have many questions for instance, ‘Should it hurt every time I feed?’ or ‘Is a small amount of pain at the start just part and parcel of the experience?’ or ‘Does my pain indicate a deeper problem?’ What follows are some answers to these important questions to help you figure out if you are on the right track or whether you should be seeking further assistance.

It only hurts at the start

Breastfeeding a newborn is challenging. There are so many things you need to get used to and proper attachment is one of the most important.

While you are learning, it’s very common to experience grazed nipples (it can feel like a carpet burn – a sore and stinging sensation). Once they are grazed, it takes time for them to heal and it’s hard for that to happen when you are frequently feeding your newborn. If you find it hurts when you first attach your baby and then after those few first sucks the pain subsides, chances are things are alright. Your nipples just need time to adjust.

To help you along, try rubbing some breastmilk on your nipples after a feed and leaving them to ‘air-dry’ as much as possible to promote healing. You can also invest in some quality cotton breast pads so your nipples are protected between feeds – just make sure to change them regularly as they can harbor bacteria if left on too long. Over time, your nipples will toughen up and get used to the frequency of feeds. In most cases, after the first few weeks the grazing should heal and the pain will subside and even, disappear!

It hurts for the entire feed

If you experience pain for the whole time you are feeding your child, this could indicate a deeper problem. Nipple thrush is one of the most common breastfeeding problems and often goes undiagnosed, causing severe discomfort for both mother and baby. It also interrupts the enjoyment of their breastfeeding experience.

If you feel itching, burning or shooting pains in one or both of your breasts during and between feeds, you may have thrush. As thrush is a fungal infection it quite easy to pass it on to your baby. Check for signs of it inside their mouth (a very thick white coating on their tongue with white spots on their inside cheeks) or their bottom (a red rash). If caught early, thrush can be treated very effectively with antifungal creams and tablets. If you suspect you or your baby have thrush, it’s important you visit your doctor or health care nurse.

It hurts when my baby feeds and I feel unwell

Blocked ducts are a common painful breastfeeding problem. They occur when the milk gets stuck in the duct, causing inflammation and blockage. You will fill a small hard lump at the blocked site and it may be tender to touch. It may only hurt before the feed but then subside during it or it could be a constant pain. It’s important you treat blocked ducts as leaving them unchecked can lead to mastitis – a very painful condition that can have serious consequences for your health. To treat blocked ducts try the following:

  • Apply a heat pack to the affected breast before feeding
  • Apply gentle massage to the area before feeding
  • Always offer the blocked duct breast first
  • Try to change your feeding position – point your baby’s chin in the direction of the blockage as their concentrated suction can unblock it (another solution - which is very left-of-field - is to request the assistance of your partner. Their suction is much more powerful than your baby’s so more likely to work.)

If blocked ducts persist you may experience a bout of mastitis. The symptoms are quite severe compared to having blocked ducts or thrush as your breasts will be painful, hot to touch, hard and even swollen. Mastitis is also often characterised by telltale red streaks across your breast. As it is a bacterial infection it is also likely you will feel like you have a flu and run a high temperature. A trip to the doctors is a must if you suspect you have mastitis. It’s not something to take lightly. Your health professional may prescribe antibiotics but will, at the very least, encourage you to drain the affected breast as often as possible and ensure you get adequate rest.

The emergence of toothy-pegs

Your child’s first tooth is an exciting time. It’s one of the first tangible ways for you to know your infant is progressing towards toddlerhood. But it can also be a painful time for your breasts. Anyone who has experienced that first chomp down on their nipple by a little one exploring their new teeth will certainly tell you it is not a fun experience. In fact, you literally see stars! Many babies will only do this once or twice and move on but if you have a serial biter, here’s a few tips:

  • A teething child can bite to relieve their discomfort. Try giving them something cold to chew on before a feed. Or give their gums a good rub with your fingers before feeding
  • Sometimes your child will chomp down because you are distracted and they want your attention. Or they may do it the end of a feed as they’ve had enough. Watch them carefully while feeding. They may get a cheeky little look in their eye before the chomp so at this stage, remove them from your breast and firmly tell them ‘no’. Do this as many times as needed
  • Try your level best not to scream or shout if they do bite you (we know it’s hard!). Screaming or shouting can create negative associations with breastfeeding or worse, he/she could think it’s a game and try again!

If all else fails, you can always talk to the fantastic breastfeeding counsellors at the Australian Breastfeeding Association as they have a wealth of information and tips on this ‘ouchy’ topic.

Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.

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