In my post about The Truth Behind Common Breastfeeding Myths, the following myth received a lot of comments on both my blog and on my Facebook page:
Myth: It’s normal for breastfeeding to hurt. Truth: If breastfeeding hurts something is wrong. Nursing may be a little uncomfortable during the early days as your body adjusts to a new sensation, but it should never be painful. Poor latch is the most common cause of pain in the early weeks, but there are other possibilities including sucking issues with baby from birth interventions or physical characteristics such as tongue-tie. If nursing hurts, get help as soon as possible. The earlier breastfeeding problems are addressed, the easier they are to fix. If you go to someone for help and the problem isn’t solved, keep trying until you find someone with the knowledge and experience to help.
A number of people have responded to say that they disagree with this, and that breastfeeding for them hurt for the first few weeks even though they had been told that nothing was wrong. A couple of comments on my blog pointed out that pain with breastfeeding is common with hormonal changes during pregnancy and ovulation, and asked why would this be different in the postpartum period? It’s an interesting question, and I don’t have a good answer. It’s certainly a possibility, and obviously everyone has a different pain threshold. The hormonal makeup of a mother after birth is different however than that of a mother who is pregnant or ovulating. It doesn’t make sense biologically for breastfeeding to be painful. Breastfeeding is supposed to be a pleasurable experience so that we’ll keep doing it to ensure that our species survives.
From my perspective as an RN and IBCLC, pain when breastfeeding indicates a problem. Breastfeeding can certainly be uncomfortable in the early days, but I strongly feel that it shouldn’t hurt. When assessing latch, it is really important to remember that a good latch is defined by how it feels, not by how it looks. Sometimes a baby’s latch can look perfect from the outside, but something is going on inside the baby’s mouth that is causing the pain.
Latch is very important, but so is a baby’s ability to suck effectively. I frequently see moms and babies where mom is experiencing pain and yet she has been told by someone else that her latch “looks perfect” and “nothing is wrong, your nipples just need to toughen up”. Usually in these cases something is going on in baby’s mouth that is causing the pain for mom. Tongue and/or lip-tie are a common cause, but another cause that is far less obvious is a sucking issue related to the birth process and/or baby’s position in utero. Birth interventions can have a huge impact on a baby’s ability to suck effectively. Vacuum and forceps in particular almost always result in sucking issues. Think about how you would feel if you were stuck in a small space and someone stuck a vacuum on your head, or grabbed your head in a pair of vice grips and pulled! Your head would hurt! Vacuum and forceps can cause irritation to a baby’s cranial nerves, and those nerves control the jaw and tongue, so it’s not surprising that those interventions tend to cause some issues with sucking. I also see sucking issues with C-sections, very quick deliveries, deliveries where there has been a very long pushing phase and sometimes the issues seem to be related to muscle tension in the baby that has likely been caused by their position in utero.
Sucking issues are not always obvious, and they usually require someone knowledgeable to identify them. Even issues such as tongue-tie are often missed by health care providers. Thankfully, sucking issues caused by birth interventions can usually be resolved with time spent breastfeeding and/or body work such as craniosacral therapy. They can however, cause a lot of pain for mom in the mean time even though everything looks “right” from the outside. So what do we do? Some people feel that telling women that breastfeeding shouldn’t hurt is doing them a disservice because it causes them to think that they’re doing something wrong if it does hurt. For most women however, pain indicates that something is wrong, although it may be something that baby is doing rather than anything the mom is or isn’t doing. It’s hard to know what is the best approach – do we tell moms that breastfeeding might hurt and encourage them to persevere through it, despite the fact that we then run the risk of moms not seeking help soon enough when there really is a problem, or do we say that it shouldn’t hurt so women know to seek help?
What do you think?
I know this is late for commenting, but wanted to share my experience. My first was born tongue-tied, and we assumed that the pain was a combination of normal first nursing pain and her poor latch. We had the tongue tied released when she was 12 days, and had her seen by an osteopath about a week later, who confirmed her suck was still week, but all of her movements where there. When the pain did not get better, I self-diagnosed us with thrush – it took a while to beat it, but just starting the treatment helped a lot. I am not sure why the midwife or lactation consultant we were seeing weren’t looking for thrush, it seems so common…
I think what Jessica said is very correct for some women, at least for me. As a mother/baby nurse and a mother of 4 children, all breast-fed for 2+ years, I was fortunate not to experience any latch difficulties. However, with my first baby around the 2nd day of nursing I did start feeling that toe-curling pain initially after latching the baby for I would say less than a minute per breast/per nursing session. It only lasted a few days, and gradually got better, till I had no pain at all. I think I didn’t have the same discomforts with the subsequent babies because I guess I didn’t have enough time in between babes for my nipples to “untoughen up”. At least that makes the most sense to me!
Also, one other thing I want to note – When my first was born, immediately after I nursed him a little and did not have pain, or much pain. The nurses took him to the NICU and bottle fed him and gave him pacifiers, and after that he would not suck right. NOT THIS TIME!! ooo no…
I need to believe that this is true. My first was a disaster for breast feeding and my second is on the way. He basically just chewed on my nipples – he flattened them out with his mouth and I was bleeding for sure, it was painful the entire time and after a few weeks I gave up and exclusively pumped, which was really hard, for another 10 months. I want very badly for this second time to be different. I believe totally that he was latched incorrectly (he should not have been flattening my nipples!) and if SOMEONE somewhere can just help me get it right with the second one I will be so relieved. I think some women should just not be afraid to admit that maybe it hurt because something wasn’t right. I’m not expecting no pain at all, but I am expecting to be more comfortable this time. Last time I thought I was doing everything fine and didn’t ask for help, this time I will be knocking down doors to get some.
Oh come off it. Breastfeeding hurt like hell for SIX WEEKS. All the experts would say this to me “it isnt supposed to hurt”. Well it did. A lot. I dreaded feeding. I took coedeine to get through it.
When I asked ‘experts’ about it they would rattle off crap about my hold and then adjust the baby up and down by about a millimeter instead of just admitting that sometimes it fucking HURTS.
What the hell is to be gained by lying to women about this?
Yes, the LLL consultant who mentioned “toe-curling” pain describes what I feel each time the baby nurses on one breast, which has an inverted nipple.
What makes it possible for baby to nurse on the inverted side is using a nipple shield, and even then it’s not great after a long day. I keep doing it not because it’s pleasurable but because I want my baby to get the health benefits and thrive.
Yes I have visited several lactation consultants (not that I need to justify why I’m still in pain) and read endless articles on breastfeeding. What I finally decided would really help is if I stopped reading nonsense like “if it hurts, you’re doing it wrong” and crying for hours feeling like a failure of a mother.
By all means, keep telling women that it never hurts. It never hurt for you, right? Every woman and every baby is different, but breastfeeding is always the same, for everyone. If it was nice and easy for you, those other women are obviously just lazy and/or wimps. That should be the message to fragile, overwhelmed postpartum women. Go breastfeeding! And once their self-esteem and sanity is ground into tiny bits, they will eagerly come back to you for more abuse. Really, they will.
I love this: “… but something is going on inside the baby’s mouth that is causing the pain.” Yeah – they are breastfeeding. That’s what’s going on inside the baby’s mouth, and it simply effing hurts for some women. It just does. When you’ve seen 5 professionals who all tell you the same thing, just exactly how many more are you supposed to keep seeing before you just realize that rabid breastfeeding enthusiasts lie to women because they know the truth is discouraging. Better that a new mother doubt herself, dread feeding her baby and feel like a miserable abject failure than think breastfeeding is anything less than perfect and wonderful and awesome for EVERYONE ELSE on the planet, BUT HER.
The problem is not that I don’t have the patience or the funds for 5 more LCs to tell me the same thing. The problem is that breastfeeding hurts for some women, even though it was just ducky for you. And if you (collective you, not you personally) won’t be honest and upfront with me about that, what else are you trying to sell me?
Thank you for this. My son is 9months old now and the first week was the most torturous experience of my life BF’ing. The LC in the hospital spent 5 minutes with us and told me b/c I showed no outward signs on my nipples of a problem, his latch was fine and basically I had to just deal with the pain. 5 days later and crying during each nursing session ( and pumping to get a break, and formula supplementing), I saw a new LC who saved us. My son had a bad latch. But he also had a bubble palate which is why he was not causing any outward damage to my nipple. He also wasn’t a gentle nurser– he is/was a barracuda in my eyes. He just dives right in with everything he has to nurse. She spent 2 hours with us on a sunday, phone call follow ups, another visit with me in tears b/c I couldn’t replicate what she showed me, and was the best support ever. Without her I don’t know if I could have made it. It took 6 weeks before nursing to even be comfortable again, but we persevered. It was to the point where I couldn’t even face forward in the shower, let anything touch my nipples, and it was awful.
I am a nurse, and I believe that my knowledge about BF’ing benefits helped me to not quit. But the fact that I was told to basically suck it up and deal in the beginning scarred me and I was thinking I just had to deal with the pain..
i’m proud to say my son only had formula supplementation that first week, and we are now 9 months in and still going strong BF’ing. And, I find BF’ing so much easier now then worrying about pumping, or making a bottle for him to go out. So much easier to just nurse!
Every new mom needs to know that breastfeeding is not supposed to hurt, and to trust your instincts that if something is wrong, go see another LC, and another, until you get your answers.
As an IBCLC and a LLLLeader I have come to believe that there is a level of pain that is normal for some women. For me the line is that the pain lasts only the first 60-90 seconds of latch and there is no nipple damage or even disfigurement. Also – for these folks that “latch-on” pain is generally gone by 1-2 wks pp. And it is pain for some – toe curling, breath-taking pain. But, as others have said, when I can give them an expectation that 1) they aren’t screwing up and 2) it will end then most moms are quite willing to persevere.
My favorite example of this is a mom friend who has had four children – the first a traditional hospital birth, but without pain medication or induction, the second a set of twins born via cesarean several weeks early for twin-to-twin transfusion, and the last an unassisted homebirth in the water. Birth weights ranging from just over 5 to just over 8 lbs. With every single one of these babies she had excruciating latch-on pain lasting for about two weeks and then went on to feed mostly pain-free (save the occasional bite or nursing during pregnancy issues) for 2.5+ years.
Would cranialsacrial have helped these folks? Perhaps – but it does seem biologically maladjusted that in infant born unassisted in the water (after a very biologically average labor) would be in need of a specialized treatment to breastfeed optimally. And unfortunately the Pediatrician in charge of the infant-risk team at the hospital where I work has banned me from referring to a chiropractor or cranialsacrial therapist (yes we are working on that).
Yes it did hurt and that made me insecure, because all the books I read stated that it was not supposed to hurt!
Now I know that its part of the deal. My son is now 2 and it still hurts when he is theething…sloppy latch at those times…
But the pain is nothing in comparison to giving birth or seeing my kid hurt his head. Part of the package of being a mom.
@ melissa the fair skin only means you are more prone to sensitivity not more prone to pain while breastfeeding. For most moms whe the pain suddenly goes away after a few weeks of breastfeeding it has nothing to do with you nipples toughening up and everything to do with baby’s mouth getting larger so they are now taking more of the areola. Which means the pain was cause by a great looking but shallow latch. and yes, this can be ameliorated much much sooner with the help of an LC worth her salt.
I am sorry you experienced such pain and thougt is was normal. I am now nursing baby number 3 and the only time in my breastfeeding years if I expereinced pain there was a problem. with one baby it was thrush with the last it was a tongue tie, we got her tie clipped @ 12 days have been pain free since then.
I have fair, sensitive skin and light pink nipples. I really believe that pain in the early weeks is unavoidable for me. It was a full 6 weeks of toe-curling pain with my first son and 2 weeks with my second. I had lots of help with latching the first time around but it really just took time for my nipples to heal. I really think that my sensitive nipples just need time to “toughen up”. Why wouldn’t it be painful? A very sensitive area is suddenly being stimulated over and over and over. Now that my youngest is 4 months, he can get lazy with the latch and it doesn’t hurt. Proof in my opinion that nipples (mine anyway) just need time to adjust.
I hear lots of women who give up in the early days because it was just too painful. What if those women were told that maybe they’re doing nothing wrong and if they just persevere, the pain will go away and it will be all worth it? Maybe more people would get through those early days if they knew to expect that.
I sometimes have let down pain but usually when more milk has started to come in after baby has demanded more feedings. It still does tend to feel a bit sore when milk comes in once in a while & he’s almost 1 year old. My friend has also reported let down pain. She had a major abundance of milk due to over pumping after every feeding. But the majority of the pain in the beginning weeks were due to poor latch. After making sure he took in most of the aerola rather than just the nipple it was so much better!
I had bruising pain that was much worse than I thought it would be. Once the bruising was healed, with help from Newman’s all purpose nipple cream, I was left with a let down pain. Sometimes it still takes me by surprise and I have to breath through the pain. My son is 8 1/2 mo old and he was born at home, no complications. Would someone please research let down pain to see how common it is?