Should breastfeeding hurt?

Nipple pain/damage is one of the most common breastfeeding complications in the first few days following birth. Nipple pain may be temporary as a result of suboptimal attachment that resolves after the latch is corrected. But it can also extend beyond this due to ongoing breastfeeding issues causing abrasions, cracks, fissures, swelling and bleeding.

So, whilst breastfeeding may not always be completely comfortable, nipple pain that extends beyond the first few days is indicative of a problem that’s warrants further attention!

Common causes of nipple pain & damage:

• Poor positioning/attachment
• Skin Sensitivity
• Short/non-pliable nipples and inability to achieve deep latch
• Failure to detach baby properly
• Infection
• Oral restrictions (tongue/lip ties)

Complications of untreated nipple damage:

• Breast engorgement
• Blocked ducts
• Mastitis
• Bacterial infections
• Poor milk removal
• Decreased milk supply
• Slow infant growth
• Early weaning

How to manage nipple damage:

• Seek support/advice early!

• Ensure optimal attachment

• Try different breastfeeding positions

• Hand hygiene and avoid touching broken skin to prevent bacterial infections

• Detaching baby appropriately by breaking the suction gently, not pulling them off the breast

• Avoid tight clothing and underwires

• Avoid harsh soaps and creams, instead apply breastmilk to the nipple and allow to air dry

• If you do need nipple cream, use purified 100% lanolin and avoid any creams that contain food products

• Try to balance moist and dry healing, either too moist or too dry will be counterproductive to healing

• Apply cold compresses after feeding/expressing to help soothe inflammation

References

Laageide, L., Radke, S., Santillan, D., Ten Eyck, P. and Powers, J., 2021. Postpartum Nipple Symptoms: Risk Factors and Dermatologic Characterization. Breastfeeding Medicine, 16(3), pp.215-221.

Mimouni, G., Merlob, P., Mimouni, F., Bin Nun, A. and Kasirer, Y., 2022. Nipple/Areola Dimensions in Early Breastfeeding. Breastfeeding Medicine, 17(6), pp.506-510.

Nakamura, M., Asaka, Y., Ogawara, T. and Yorozu, Y., 2018. Nipple Skin Trauma in Breastfeeding Women During Postpartum Week One. Breastfeeding Medicine, 13(7), pp.479-484.

 Written by Keryn Thompson, RM & IBCLC (L-301766)