Top 3 Reasons You Have Nipple Pain with Breastfeeding
Breastfeeding can be a great way to bond with your baby and provide them with nutrition, and antibodies to protect from disease. It can be a little uncomfortable at first to find a position that works for you and for baby. Nipple pain with breastfeeding is the most common concern I get from new parents. With breastfeeding it is common to feel tugging, pulling or some degree of suction. Pain is not normal.
In this article, I will go through the top three causes of nipple pain with breastfeeding and when to seek out further assistance.
The Latch
This is hands-down the top reason that most parents experience nipple pain from breastfeeding [1]. This pain can be felt during the latch and may even persist through the whole feed if the baby does not get deep enough onto the breast. After delivery, have your doula or postpartum nurse help you with latching. If there is a lactation consultant on sight, it would be great to request their help as well. In research, having some sort of postpartum support can ease breastfeeding pain through non-pharmacological approaches even if it is just through verbal reassurance [2].
Keep in mind that even if your baby seems to have a “good latch”, based on the way it looks, pain indicates that a further investigation needs to be done on the latch and mechanics of the baby’s tongue and mouth. The general rule of thumb is to aim for an asymmetric latch, where your nipple is pointed towards the roof of your baby’s mouth at the junction of the hard and soft palate. To conceptualize where this is, run your tongue from behind your top teeth to where your palate changes texture from hard and ridged to soft and smooth. Yes, that far back!
Your baby’s head should be extended back so you can see their nostrils, with their chin touching your lower breast tissue. A baby whose head is flexed forwards is essentially biting down on your breast, and as you can imagine, that would be quite painful.
Head, Neck and Body Tension
Babies go through a lot during the pushing stage of labour, when they are in the birth canal. They are squeezed, and rocked back and forth over the pelvic bone, which is why their heads may come out in funny shapes. If there is any sort of tension in the baby’s body, this can make it uncomfortable for them to open their mouths wide enough to get a deep latch. As we learned from the section above, this can cause pain!
Keep an eye out for single-sided breast pain because this could mean that your baby has difficulty turning their head in one direction, or opening their mouths towards that side. Your practitioner can also assess for body tension and mechanics of your baby’s tongue. This includes seeing how far to each side of the mouth their tongue can move. The practitioner can also assess for the presence of a tongue or lip tie. Consult with a breastfeeding expert, IBCLC or infant dentist to assess your baby for the presence of a tongue or lip tie.
For bodywork, I always turn to infant osteopathy. Osteopathic practitioners can perform gentle, light touch movement of soft tissue. You should notice immediate changes with breastfeeding and lasting changes after four to six osteopathy treatments in many circumstances.
Tongue or Lip Tie
*There are different types and classes of these “ties,” some of which can still maintain proper functionality of the tongue and lip to drink from the breast.
A tongue or lip tie is when there is extra tissue growth which prevents the tongue or lip from moving to its full capacity [1,3]. The tongue is responsible for maintaining suction around the breast tissue, while sucking from the back of the breast, forwards. With a restricted tongue, this prevents the tongue from moving high enough in the mouth to stimulate the breast tissue for a let-down. A restricted lip can prevent a tight seal around the breast. Moreover, all of this creates the environment for a shallow latch and an ineffective feed, so you may notice your baby getting fussy at the breast.
Keep an ear out for clicking when your baby is drinking, or you may see small, painless blisters on their lips which is a sign that they are clinging onto their breast with their lips rather than their tongue and whole mouth.
Have a breastfeeding expert, IBCLC or infant dentist assess your baby if you think this is the case, or if you still have no relief after adjusting their latch. If there is a type of tie present which is greatly affecting your baby’s ability to latch, they may require a procedure called a frenotomy, which is when the extra tissue is snipped with either a laser or a pair of sterile scissors [1].
Still Having Pain?
There are other underlying conditions which can also cause nipple or breast pain. If you notice any redness, experiencing a burning, or throbbing pain in your breast or feel any hardness or engorgement, please seek extra help from a healthcare practitioner or feel free to book an osteopathy session today!
References:
Pereira Coca, K., Marcacine Oliveira, K., Antar Gamba, M., Correa, L., Correa Aranha, A., Freitas de Vilhena Abrao, A. (2016). Efficacy of low-level laser therapy in relieving nipple pain in breastfeeding women: a triple-blind randomized controlled trial, Pain Manag Nurs. 17(4), 281-289.
Milinco, M., Travan, L., Cattaneo, A., Knowles, A., Vittoria Sola, M. et al. (2020). Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial, Int Breastfeed J. 15(1), 21.
Ito, Y. (2014). Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia, Pediatr Int. 56(4), 497-505.