Going from “Ow” to “Wow”: Overcoming Painful Nursing
My friend May gave birth to her first baby at the end of December. Like many new mothers she is struggling with nipple pain and asked me for a few tips. Pain while nursing puts many people off breastfeeding or discourages them enough to give up. We want you to have the best start possible when nursing your baby. This week I offer some tips to overcome painful nursing and when it is time to call in the experts to help you with some more serious problems.
It is completely normal to experience some pain when you first start breastfeeding your baby. Your nipples are not used to this kind of stimulation and they may take a few weeks to toughen up. If you have pain for a few seconds when your baby first latches on in the first few weeks this is completely normal.
There are some things you can do before the baby is born to prepare your body for breastfeeding:
- Retrain yourself to wash your breasts with warm water but without soap. Your nipples and areola secrete natural antibacterial oils that help prevent infection and cracking. Washing them with soap removes the oil and chaps and irritates the breasts increasing the risk of infection. Pat them mostly dry with a towel and leave them to air dry.
- Use a baby-safe pure lanolin product on your nipples beginning a few weeks before you give birth. This prepares your nipples for nursing. Continue doing so after the baby is born and allow your nipples to air dry naturally after each feeding. Remember, lanolin tends to stain clothing until it’s dry so it is best to try and be topless for while after applying.
Both these suggestions help prevent sore, cracked nipples. If you have a good latch and proper positioning you are well on your way to avoiding sore nipples.
Latching on is what your baby does when its mouth and tongue grasp your breast, normally around the areola and nipple. Positioning has to do with the way you hold your baby. You can find more information and video demonstration of the correct way to latch your baby here.
To get your baby in the right position, make sure the baby’s ears, shoulders and hips are in a straight line. Put your hand behind the baby’s neck and head to support it. Your other hand holds the breast the baby is feeding from. The hand supporting your breast should be curved into a C shape. Your thumb is on top of the breast and the rest of your fingers are underneath. During the first six weeks of breastfeeding you should always support your breast with your hand.
When the baby is ready to latch on, tickle his lips with your nipple. Wait for the baby to open his mouth really wide, lift your breast with your hand and put the whole nipple into the center of his mouth. Simultaneously, use your other arm to bring his head closer to you. The baby’s mouth will close and latch onto the areola (the pinky-brown circle of skin around the nipple) and his tongue will sit under the nipple. Soon your baby will be latching like a champ and all this talk of technique will be a distant memory and you’ll wonder how it didn’t all just come naturally before. Check out more on breastfeeding positions and watch some how to videos.
A plugged milk duct is another reason for painful nursing. You can identify this by a lump and a sore breast. To help ease your pain and unclog the duct:
- Massage the area and take warm showers or use a hot compress a few times a day to help move the plug. Breastfeeding your little one focusing on the side with the lump.
- Position your baby so the nose is pointed towards the clogged area while nursing.
- Use a breast pump for a few minutes to help draw out the clogged milk.
The lump should go away after a few days. If not, or you have a fever, chills, aches or red streaking, it is important you contact your doctor immediately as this may have progressed to mastitis.
Mastitis is an infection of the milk duct where you experience flu-like symptoms. You will have sore breasts as well as fever, chills and a hard or red area on your breast (possibly a red line). It is important to call your doctor immediately so that you can be treated with antibiotics.
Thrush, a yeast infection in your breast, is another cause of pain while breastfeeding. You need to speak to your doctor if you have any of these symptoms:
- shooting or burning pain in your breast either during or after feedings
- pain deep inside your breast
- strong pain in the breasts or nipples that doesn’t improve after correctly latching and positioning your baby
- cracked, itchy, burning nipples as well as pink, red, shiny, flaky nipples or those that have a rash with little blisters
Babies can also suffer from oral thrush. They can have cracked skin in the corners of the mouth and whitish or yellowish patches on the lips, tongue or the inside of their cheeks to indicate thrush. Your doctor can prescribe an antifungal medicine for both you and your baby to get on top of the thrush and to prevent you from passing it back and forth to one another while breastfeeding.
Women with inverted or flat nipples can have problems nursing and may have frequent nipple pain. Inverted nipples turn inward rather than pointing outwards. Flat nipples don’t easily become erect when breastfeeding your baby. Your doctor or a lactation consultant can offer advice on how to solve these problems and relieve the pain.
Some babies are born tongue tied. This has nothing to do with their limited vocabulary when they’re little but rather where the frenulum, the ridge of skin under your tongue, is attached too tightly to the baby’s tongue. This causes your baby to have a poor latch or makes it impossible for him to latch on at all. Pediatricians or lactation consultants can diagnose this and discuss options with you. If your baby is tongue tied they can snip the frenulum to loosen the tongue or slowly stretch it to increased the range of motion of their tongue and this will help your sore nipples.
Lastly, here are a few pointers to keep your breasts healthy and pain free so you can focus on enjoying breastfeeding your baby:
- After nursing rub some breast milk on your nipples and leave them to air dry.
- Begin breastfeeding on the side that is less painful if you’re already experiencing pain.
- When breaking your baby’s latch slip your finger inside your baby’s mouth and gently release the latch from your nipple instead of simply pulling the baby from your breast.
- Use varied nursing positions to help empty your breasts completely.
- Before nursing put wet or dry heat on your breasts with a warm water bottle, heating pad, wash cloth or try a warm shower. (Do not do this is you have a yeast infection as you need to keep your nipples dry to help clear up the thrush).
- Use ice packs, cool compresses or cabbage leaves on engorged breasts after breastfeeding.
- Gently massage the painful area before breastfeeding your baby.
- Get plenty of rest and fluids. This may be challenging with a newborn but get the help of your family and friends.
- Pumping for a few days may give your nipples a break and then you can return to nursing as normal.
If you are frequently unable to breastfeeding without pain please contact a doctor or a lactation consultant. A lactation consultant was so important in helping me resolve my issues and continue successfully nursing my son. Search this list of lactation consultants worldwide to find one in your area.
I hope these tips will help you spend more time simply focusing on enjoying the special time breastfeeding your baby. Let’s keep our babies boobie fed!
References:
http://www.aafp.org/afp/20010915/991ph.html
http://kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&cat_id=161&article_set=44020
http://www.womenshealthcaretopics.com/thrush.htm
