Pain during breastfeeding is not normal: Know when to ask for help

Many new mothers are told that breastfeeding is supposed to hurt. That is one of the biggest myths surrounding breastfeeding.

During the first few days after birth, some discomfort is common. Every time the baby suckles, the mother's body releases oxytocin, the hormone that helps the uterus return to its normal size.

At the same time, the nipples get used to breastfeeding and stretch for the first time. This is often called nipple stretch pain. The discomfort is usually felt only during the first few seconds after the baby latches, settles quickly and gradually disappears over the first few days as both mother and baby learn to breastfeed together.

But if the pain continues, becomes worse or makes you dread every feed, something is not right. The most common reason is a poor latch. If the baby is not attached deeply to the breast, the nipples can become sore, cracked or even bleed.

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Mothers often describe it as a pinching or painful pulling sensation. The good news is that correcting the baby's position and latch usually brings immediate relief.

Pain can also occur when the breasts become very full and hard, a condition called engorgement. Frequent feeding and effective milk removal usually help.

Sometimes a blocked milk duct causes a painful lump. If the breast becomes red, swollen and painful and you develop fever or body aches, it could be mastitis. In most situations, early treatment can help mothers continue breastfeeding safely.

Another pattern is a burning or stinging pain that becomes more noticeable towards the end of a feed and continues after the baby has finished feeding. This may be caused by a bacterial infection, a fungal infection or less commonly vasospasm, where the blood vessels of the nipple temporarily tighten. Although these conditions can feel similar, the treatment is different. It is therefore important to have the pain assessed rather than trying home remedies on your own.

The baby's mouth also deserves attention. Tongue tie, lip tie, a high arched palate and other differences in the baby's oral anatomy can prevent a deep latch. This may lead to ongoing nipple pain, poor milk transfer and slow weight gain.

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A good breastfeeding assessment should always include both the mother's breasts and the baby's oral anatomy as well as an observation of an actual breastfeed to assess latch and milk transfer.

Most breastfeeding problems can be treated successfully when they are recognised early. A paediatrician or an International Board Certified Lactation Consultant can usually identify the cause and help mothers continue breastfeeding comfortably.

Breastfeeding should bring comfort to both mother and baby. A little discomfort in the beginning is common. Ongoing pain is not. The sooner you ask for help, the easier it is to find the cause, solve the problem and enjoy your breastfeeding journey.

Dr Ravneet Joshi is a Consultant- Lactation Specialist at Manipal Hospital Old Airport Road, Bengaluru