My Baby’s Latch is “Perfect” so Why Does Breastfeeding Hurt?

Stating “breastfeeding shouldn’t hurt” always draws a lot of comment from mothers who unfortunately did have a lot of pain with breastfeeding. Many mothers who are having pain find that the pain suddenly disappears after a few weeks or months. Why does this happen? Is it simply a case of it being  normal for some women to have pain? As I’ve mentioned before, I don’t think it is. Pain, especially “toe-curling pain” while nursing is NOT normal, but I do know that it is sometimes hard to find an answer as to what is causing the pain.

The most common reason for pain when nursing is that your baby is not latched on properly, but what if your baby’s latch seems to be OK? I work with a lot of moms who are having pain with breastfeeding, and they often tell me that they were told by another care provider that their baby’s latch looks “perfect” so there shouldn’t be any pain. This leaves moms feeling confused, frustrated and feeling like they are doing something wrong. How a baby’s latch feels, is far more important than what it looks like from the outside. Some latches do look “perfect” from the outside and yet something is going on inside the baby’s mouth that is causing problems (and some latches look “wrong” from the outside, yet mom isn’t having any pain and baby is nursing effectively, so everything is good!).  If a baby is truly latching on well but mom is still in pain, the two main reasons for it that I see in my practice are tongue and/or lip-tie and structural restrictions caused by delivery or position in the womb.

Tongue and lip-tie: Many years ago, tongue-tie was routinely checked for, and clipped at birth. As society turned more towards bottle feeding, this practice fell out of favour because tongue-tie doesn’t usually cause any problems with bottle feeding (although it certainly can!). Because of this, the knowledge about tongue-tie has been lost and many health care providers know very little about it, or don’t see it as a problem. Today, as more and more women are breastfeeding, we are struggling to regain that knowledge because tongue and lip-tie certainly have an impact on breastfeeding.  Posterior tongue-ties in particular, (where the frenulum, or membrane under the tongue is attached towards the base of the tongue rather than the tip of the tongue) are sneaky, and easily missed by many health care providers. If you are having pain with breastfeeding and your baby’s latch looks good then it’s important to have your baby checked for tongue and lip-tie by someone knowledgeable.

Structural restrictions due to birth interventions or baby’s position in utero: This one is largely overlooked, and is probably the biggest cause of pain in those situations where everything “looks” ok, tongue and lip-tie have been ruled out,  but breastfeeding is still painful. Birth and breastfeeding are closely linked, and there are many things during labour and delivery that can have a direct impact on breastfeeding. Birth interventions such as vacuum, forceps or c-section tend to be the most common causes of structural issues, but sometimes even in an intervention free birth there can be structural issues due to the baby’s position in utero.

Forceps and vacuum extraction can cause bruising and swelling of the head and face, and due to the pressure exerted, they can cause distortion of the cranial bones. Although a baby’s cranial bones are designed to move over one another as baby descends through the birth canal, the forces exerted by vacuum or forceps can often cause shifts in the cranial bones that are not easily self-corrected by the baby after birth. All of these things can cause irritation to the baby’s cranial nerves, and it is the cranial nerves that control everything through the mouth and jaw. This irritation can lead to alterations in sucking patterns that result in pain for mom, and/or ineffective milk transfer. These babies may also be generally fussy due to discomfort. Imagine how you would feel if you were pulled or vacuumed out of a tight space by your head!

Babies are meant to pushed out by mom’s uterine contractions, so when a baby is delivered by C-section, or even when a well-meaning doctor tries to speed up a vaginal delivery by pulling on the baby, it can cause structural issues within the baby’s spinal cord that can affect sucking. It can also result in a strong preference for nursing on one side over the other, pain on one side but not the other, or even an inability to latch at all on one side. Even when there are no interventions during delivery, sometimes the position that a baby is in while in utero can have an impact on breastfeeding. If a baby is stuck in a certain position it can cause tightening of the neck muscles on one side, or even torticollis. I’ve also seen jaw distortions in babies who spent a lot of time in utero with their hand pressed against the side of their face. Again, these things can cause sucking issues or issues with baby being unable to achieve a comfortable latch/position.

Many of these structural issues do work themselves out eventually, or the baby learns to compensate for the restrictions and is eventually able to nurse effectively. This is why many moms find that the pain eventually goes away. In the mean time though, mothers struggle with unnecessary pain and often a very frustrating breastfeeding relationship. There are however ways to help. Many parents find that in these situations, complementary therapies such as chiropractic care and or craniosacral therapy can make a big difference for breastfeeding. There are other complementary therapies as well such as osteopathy or Bowen therapy that can also be very effective. The important thing to keep in mind that when choosing a care provider is that you want to find someone who is trained to work with babies and has experience doing so. If complementary therapies are not a possibility, or not something you are comfortable with, infant massage may also be beneficial (and is a wonderful way to connect with your baby). If you’re wondering whether your baby may have structural issues that are contributing to your struggles with breastfeeding, this article by Dee Kassing provides great information about some of the things to look for. This post from Renee Beebe is a great example of the difference that skilled bodywork can make.

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  8. What about the case when breastfeeding hurts *because* the latch is bad, but you simply cannot fix it? I’ve been breastfeeding my little one for 2 years now. The excruciating pain from the beginning has faded, as have the vasospasms, the milk blisters, the nipple so injured that I could not breastfeed on that side for 3 days. But even now after 2 years breastfeeding often hurts. Not a ton, and not always, but often. It feels pinchy, or like someone is biting me (even though she’s not). When my now-not-so-little-one is done nursing, the nipple looks creased. But I don’t know how to change it.

    I’ve seen the (one) local lactation consultant. I’ve been to La Leche League meetings. I’ve had LLL volunteers come to the house. I’ve skyped with another lactation consultant remotely. I’ve taken my daughter to an osteopath, and for craniosacral therapy, and to physical therapy. Nothing has completely fixed the problem.

    Is our situation unheard of? Has anyone else been in a similar boat?

    • This is exactly how my boobs feel while breast feeding. My left more than my right. But both hurt while breastfeeding. When she first latches on especially to the left breast it is very painful but then turns to slightly less painful but like you said feels like you said a pinching or biting feeling going through my breast. I make sure her tongue is down and she takes more than just the nipple into her mouth yet it still is painful. I don’t understand it either. I’m hoping it gets better I’m only on day 5 of breastfeeding.

    • It may be thrush internal inside the nipple FLESH. I suffered from that through a few babies breastfeeding and the only thing that helped was take oral pills against thrush called Fluconozole, but even after than the thrush returned after a few months because I seem to be prone to it…………..

  9. I know it’s hard to hear, but if you are having excessive pain, something IS wrong. You can write it off as general soreness, just as I did because I had no explanation and couldn’t figure it out, but you need to know that something needs fixed! I had MONTHS of painful breastfeeding. I am talking about painful as in burning feelings during and in between feedings, and later on I had sharp pain with feedings and feelings of bruising in between. At first, we (lactation consultant and I) figured out that I had yeast on my nipples. 14 days of antifungal medications (prescription, by mouth) helped and improved the burning within a day or two. I was still having a bruised and sore feeling for another month. Baby’s latch was beautiful (per lactation consultant) and so I knew it had to be something else. I finally figured out, after 3 months of nursing, that my pump flanges were the wrong size. Medela’s smallest size offered was a 21mm. These were still too big causing a lot of pain! Amazon has a company that makes smaller sizes (15, 17 and 19mm). Life changing and no more pain!! Having great experiences with breastfeeding now, FINALLY, with my 3 1/2 month old! Keep sticking it out and be persistent about finding the problem… it is so enjoyable once it is going well!

    • How long did it take for nipples to heal? I’m so blessed I saw this post. I’ve been in so much pain. I just ordered smaller flange sizes. Thank you so much!!!!

    • JASmith says:

      Ugh. I think this is me. 7 month old and still in pain. Slight to severe. . . I think I may have thrush- burning stinging etc. And I think my flange size sucks. I got the pumping pals set… But not 100% if it’s the right fit. Going home. going to the LAC to find out. Was your LAC able to tell you by watching what your flange issue was?

  10. Renae Heath says:

    Okay everyone-if you are in ANY kind of pain…. read this post!! last night I had the night from absolute HELL, I am not exaggerating! It felt worse than my natural childbirth, no drama. I had never cried so hard and so much in my whole life and my baby and I didn’t sleep all night! Not to mention my poor husband was near tears. To top it off my boobs felt like someone was SEARING them off with a steak knife!! my entire body was sore and achy cause every time he latched on (wrong) I would tense my entire body, tighten my muscles and count through the first 15 seconds, cry or scream, seriously like a damn contraction! Then the rest of the breastfeeding session would look like this: scream, ow, ow, ow, ow, ow, ow, tense up, want to die, ow, ow, ow- for every suck. Omg. I wish I’d read a post somewhere in those wee am hours exactly what I’m about to write to you….CALL A LACTATION CONSULTANT ASAP!! Breastfeeding should not be excrutiatingly torturous!! the next morning I immediately went back to the hospital where I delivered and made a free appointment with a lactation consultant. She changed my life!! She is like a boob angel! I was doing all the techniques just a little bit wrong enough for me to feel like I was going through absolute TORTURE! it does NOT have to be like that!!
    Go back to your delivery hospital, make the trip, delirious and all, the NEXT morning. Call TONIGHT at 3AM and leave a message!! If it’s a Saturday, call a private one in your area. PAY THE MONEY. My hospital consultant was FREE. yes, free, NO charge for heavenly breast feeding! It is worth it, believe me.
    In the meantime, try this:
    1. Sit on the edge of a chair, with arms, so your back is straight up. Use pillows, rolled blankets, BOPPIE, ANYTHING you can find to make it so that your pillow and baby are evenly up aligned with your boobs, without you having to prop the pillows up during the feeding.
    2. Align your baby so that his belly touches and faces yours (as much skin to skin as possible). His body should be in a straight line against yours. This is also true for football hold, against your side. straight line.
    For other holds, skip to 4.
    3. For football hold, line up his bum right under your elbow and armpit. Tuck him in snuggly with your elbow. Again, his belly towards your body. SO important.
    4. Your hand gently supporting his nape of his neck, fingers ONLY supporting his head. Important.
    Other hand: make a C grip around the outside of your areola. Pinch and squeeze, shoving the nipple and areola out. Press breast against your body. You are making the nipple stand out and better fit for his little mouth.
    5. Wait until he opens WIDE.
    6. Touch the top of his lip with the top of your nipple.
    7. In the SPLIT second after this, SHOVE and SCOOP his bottom part of mouth on the rest of nipple and areola. You only have a second. It ok, go through the steps, visualize it and practice before.
    *** you bring your baby’s mouth and head to YOUR NIPPLE AND BOOB. bring him to you.
    Continue to hold and squeeze your boob with a C, DO NOT LET GO!! The entire session!!
    You should also be holding his head with your fingers the entire session.
    8. Don’t get frustrated, if he doesnt latch, resituate and try it again.
    His latch should be deep and he should start sucking asap, with little to no pain!
    9. Sitting up, your back may hurt. This is NOTHING compared to your previous nipple pain. Reclining doesn’t work when they are so little.
    10. There should be little to no pain!
    If this doesn’t work, don’t worry, you are only hours away from pain relief and seeing your lactation consultant!

    I know half my cry was because I felt like I was failing as a mom..I mean I couldn’t even feed my own baby!
    Remember you are BOTH learning.
    And call that damn consultant, tell her you need to see her today!!
    Good luck!

  11. Nice article, very helpful. There are some things missing though, maybe they can be found somewhere else on the site, but I’ll share anyway.

    Smart mouth comments and snide remarks of midwives, lactation consultants and other “expert” mothers drove me nuts…
    Even though I was lucky cause I could feed my boy right after I gave birth to him (still with the navel chord, he made a little beak and searched for the nipple) I had quite some trouble the first days. Everyone said the latch was perfect, but it wasn’t, the boy was not taking in enough of the nipple. So I opened the latch with my finger and had him try again till he got it right. This is a team effort! We trained the latch together and I talked to my child! This is not just a helpless, stupid little thing, it’s an intelligent being. Some things make common sense. I was hurting immensely in between, with the milk shooting through my breasts filling up again, and that’s normal – some of us ladies have wider ducts, some have tighter ducts, so it hurts more, especially if you have lots of milk. I did get a yeast infection in week two, treated it with — yes, it works like a charm — coconut oil. Gone after 3 days. Also treated the boys mouth with it. Also works much better and is far more healthy and natural than lanolin, which is total crap – lanolin is part whool wax (basically skin grease) of sheep and paraffin ( which is mineral oil / petroleum). It’s just like oil-based lubricant, but has no healing properties whatsoever, unlike coconut oil, which is full of vitamins and other stuffs, plus it’s antifungal and antibacterial!
    Also, my midwife put us on a feeding schedule, which is, sorry, the most idiotic thing I’ve ever encountered. I got off the schedule an day two when I could think properly again. This is a new life, each baby grows at its own but high pace. Feed on demand! You learn quickly when your baby cries for food or just for attention, and you cannot over-feed with breast milk. Plus, the saliva and your nipple skin “communicate” — it’s been proven that the milk changes based on the child’s needs ( different fat and protein contents, other antibodies, etc..). A starved babe that has been hungry for more than 5 minutes will latch on too tight – and hurt the nipple, and the too hard suction hurts the ducts. Again, common sense.

    Even though there are many competent experts such as nursing consultants, midwives, doctors, etc. who do great work helping us, there are many more who are just being smart. Human beings (and other mammals by the way) have been doing this for millions of years. We’ve been taught to listen to “Experts” instead of to our own bodies, and just do the things we were born to do. There are situations where women have done all they can and it still doesn’t work. They should receive the help they need. But don’t confuse us with half-truths. Nursing will hurt for most at some point. However, it shouldn’t be a constant hell for many either.

    RELAX. Even when it hurts. Nursing is a highly sensitive house of hormone cards, and stress is a killer of everything. Relax, look at your beautiful baby, talk to it, bond with it, correct the latch, change the babies position (lying down to the left, to the right, upright) and see if it’s just the direction she takes in your nipple.
    It’s not always either tongue tie, fungus or latch. There’s much much more in between.

  12. I have had so much pain with breast-feeding! My wonderful lactation consultant diagnosed yeast infection on the nipples. Also thinks my LO has yeast infection and we are passing it back and forth. Was discussed with my last episode of breast-feeding that it was thought I had yeast infection in the ducts. That felt like shooting pain throughout my body. I quit breast-feeding due to that. Had I known what it was at the time with a proper lactation consultant I would have continued. Loving the fact I can breast-feed now!

  13. Jessica says:

    Jennifer, your story is exactly like mine! My baby is 6.5 weeks old and we’ve tried practically all the things you did. I came here when I googled “breastfeeding still hurts,” and your post encourages me to suck it up a little longer.

    I’ve been obsessed with weaning him off the shield, and I almost have, but of course the pain is much worse without it. I’m so hopeful it will get better.

  14. So, when I tried to look up info on CST I found one article about a 3 month old who died while being worked on and several articles about how CST is “quackery”. I’m willing to try a lot to improve this pain but nothing that might endanger my daughter. How does one know a practitioner is competent? What credentials should they have? And what might I see to alert me to grab my babe and get the hell out of there? Are there less invasive options that CST? Any recommendations for the Ottawa area, Fleur? Thanks!

    • Right, and birth isnt supposed to hurt either! Just because its natural doesnt mean it doesnt hurt like crazy. I’m sure you are a nice and well meaning lady, Fleur, and there is often excessive pain due to some problem and i bet you have helped a lot of families, but this reply above indicates how harmful the whole, “it shouldn’t hurt” spiel is. Before i had my first, i was more afraid of messing up breastfeeding than i was of giving birth. So i took a nursing class at Kaiser and it was awesome. The lactation consultant instructor said, “of course it hurts. A person is sucking on you.” For hours a day, i might add. On very sensitive tissue. She told us how to minimize pain, but thinking it shouldn’t hurt only convinces women there is somethig wrong with them or with their baby, leading them to try nutso things that are harmful, or to just give up because they think theyll never get it right and werent told ahead of time theres usually some pain at least at first. Good grief. I bet that poor mom of that dead three month old would give anything to be yelping in pain to nurse that child again.
      My third baby, now four months and breastfeeding like a champ, was tongue tied. The pediatrician who saw him at the two day appt spotted it and showed me how to stick my finger in his mouth and massage it to draw it forward. No need for snipping. I only did it like twice because a lot of other things were going on at the time, but as he grew, it just resolved itself. The postpartum nurses also said breastmilk works even better than lanolin for cracking and they were right. We were designed to do this, mamas, but it doesnt come without pain. I say this with a milk blister on lefty and having just recovered from a plugged duct in righty.
      So strike a balance, please, lactation consultants: dont sugarcoat this for us, just help us do the best we can and then have the motivation to set our teeth and do it.

      • I am sorry Fleur, to be somewhat harsh. I dont know how it is in Canada, but in the U.S., nursing can be a real uphill battle sometimes, socially speaking. We just dont have much support outside the healthcare system encouraging us to even try in the first place. I have known too many moms who give up because they were under the impression it was supposed to be painless, come naturally, etc. Sorry to take my frustration out on you.

  15. fairy_thale says:

    Being a breastfeeding mom isn’t that easy????
    Though it is so painful looking my baby well fed and healthy. A happy baby, the pain is nothing.

  16. Jennifer says:

    I had excruciating pain when I first started breastfeeding. It felt like a thousand pins and needles were passing through my breast with each time my son attempted to suck. I was in so much pain that during my visits to the lactation consultants, I could only demonstrate the latch for a few moments because it hurt so much. I was not bleeding, but very red and just extremely sensitive. I ended up having to supplement with formula (fortunately this only lasted a few days) and finally saw a great consultant who focused more on healing me and was alright with my brief formula supplementation and recommended pumping. One medicated ointment, two containers of Lanolin, a hospital grade pump, three different sized breast pump phallanges, salt baths, soft shells, softer nursing bras, nipple shields, and a frenectomy for my son (which I agree was painless), and many many tears. ..and around week 5 it became much easier. Still not 100% pain free or enjoyable, but definitely tolerable. Not sure what it was exactly that helped…could have just been that it took some time for my breasts to toughen up. I can say that his latch did not significantly change, although we did end up using the shield (and still do). I am convinced some people are simply more sensitive than others and wish that this was something the consultants would admit, given the number of people who have this problem. But things are definitely much better now At 8 weeks. I had to exclusively pump and bottle feed for about 2.5 weeks, but was able to gradually re-introduce nursing with no confusion, and now only pump for convenience. I’m writing this to let you know that it does get way better soon, and these types of postings were the only thing that got me through the whole ordeal. Hang in there and do what you need to do in order to stay sane, even if that includes a bit of formula.

    • Thank you for sharing. It has been so very very painful for me as well. I have gone to a consultant twice and had several nurses helping me while in the hospital. The shield helped me, but them around 7 weeks I came down with mastitis twice and experienced full on flu symptoms and terrible discomfort. When I went in, the midwife said I also had yeast infections on both nipples. I am currently still on antibiotics and had to get rid of the shields while trying to heal. The shields were a huge help since my nipples are “flat.” Now that we have gone without them I have bled more than ever from my nipples, and all anyone says is “well she seems to have a good latch and good positioning.” So long story short, done the creams, prescription ointments, shield, antibiotics, different positioning, and it is still very painful. It’s hopeful to hear that there is still a chance for it to get better.

  17. I had severe pain as well. It was only on the left breast too. My left nipple was so sensitive I would cause pain somewhere else on my body to try to trick my brain! It kind of worked, but I always thought, “this is NOT NORMAL, why do I have so much pain even though I have “perfect” latch!!!” I pursued advice from midwives/, La Leche Leagues, etc. No one knew why.
    Unfortunately, a lot of these reasons listed above didn’t fall into my category either. I had my son at home without any interventions at all. He also, does not have tongue/lip tip either. The pain has mostly gone away (he is 8 months), but still NOBODY knows the cause! 🙁

    • Christelle says:

      I can totally relate. I just had my 8th baby, he was born at home with a midwife. I have had pain with ALL of them. I saw lactation consultants, midwives … it cannot be that they all had a bad latch. They always told me the latch was fine. I tried all the tricks out there and every time have moments of discouragements because I would LOVE to just enjoy breastfeeding my babies. He is not tongue tie and is a good eater.
      I have come to the conclusion that for some woman that is just the way it goes. I think my nerves or ligaments are super sensitive and need time to stretch and adjust.
      It is encouraging to know I am not the only one though!

      • WOW! I just had my 8th baby too and nursing always hurts for me too. I have finally concluded I just have really sensitive nipples. With some it resolved sooner than others, but even to the end of 6 months (when they all weaned themselves from me) it has never been painless at any point. I am 1 week in this time and struggling a lot with this one- he is a super hard sucker… I am having to pump and offer bottles in between feedings because I need breaks and my nipples are super sore (to the point of tears)!!!
        Glad I am not alone!

  18. Christina says:

    There can also be pain with vaso spasm (Raynaud’s), yeast infection, or bacterial infection.
    I love the sharing about the cranial nerves! What a great point. Chiropractors that are competent in this area can help with adjustments!

  19. Great post and even better conversation thread after it. This has really helped me to see that I am not alone in the pain and dissapointment I’ve been going through. My daughter was born via forceps, the scar is still on her face 5 weeks +4 days pp so it must have been traumatic for her being yanked out so strongly.

    I’m in pain every time I breastfeed & have nipple blanching when she finishes. My right nipple is flat and absolutely kills to nurse (even with a nipple shield on) so I express from that side as frequent attempts to nurse on that side have left the nipple cracked and bleeding. She has a super strong suck and clamps down really hard which I am sure is what is causing the pain. After reading this article I won’t give up and will try to persevere with the breastfeedig and cut down on the formula feeds as I only resorted to formula out of pressure from my mum & feeling that I didn’t have any other choice. Good to know some women experience pain till 8 weeks – doesnt make me feel like such an anomaly now.

  20. Tongue tie is SO common and do easy to fix if its caught early. My son was born 2 months premature and in the nicu for 6.5 weeks but no one ever noticed that he was a text book tongue tie case. It was months later when I developed thrush that my lactation counselor noticed the problem. Two seconds and a drop of blood was all it took to get a perfect latch!

  21. Hi,

    I was interested to note that you have not mentioned anatomical issues that can cause pain or vasospasm. Vasospasm affects up to 20% of breastfeeding women and can cause terrible pain. It look visiting my THIRD lactation consultant to diagnose the issue, and that was only because I mentioned how the nipple blanching in colour and hurting.
    Flat or inverted nipples can cause pain as the skin begins to stretch out.

    • Fleur (Nurtured Child) says:

      Thank you for your feedback. 🙂 This wasn’t meant to be an exhaustive list of all the things that can cause pain (that’s coming as I continue to add to my website!). I was highlighting two of the common (but less well known) reasons for pain that I see in my practice. Vasospasm can certainly cause a lot of pain and it is usually triggered by trauma to the nipples from a poor latch, or other issues such as tongue-tie. Fixing the initial cause of the trauma is an important first step when it comes to dealing with vasospasm.
      Truly inverted nipples can cause pain as the nipple is drawn out and adhesions are broken down. Pain from “flat” nipples is usually related to difficulties with latch.
      I’m sorry to hear that it took you several tries to find an answer for your pain. Good for you for sticking with breastfeeding and for continuing to look for answers!

      • Help! My baby is 4 weeks and this week, he’s been sucking so hard that the skin on my nipples is peeling off- I am dying!!!! He was born naturally and I wasn’t having this problem until now! I bought the nipple shield, but that was a disaster! I cry every time he wants to feed- I have to embrace myself- my nipples are a mess- they burn in between the feedings as well!

    • Andy, can you tell me more about Vasospasms? I have an EBF 7 month old, and I’m still battling with pain daily. Obviously the beginning was the worst. Breastfeeding my daughter for 6 weeks was a bazillion times harder than her natural homebirth. Even thinking about it now makes me want to cry. Anyway, lately I’ve been frustrated that I’m still in pain because I am a HUGE breastfeeding advocate, and want to really love breastfeeding (I loved it with my son even though we did have a rocky start with pain), but I am often annoyed and irritated. My daughter sucks like a Dyson. She has always had a super strong suck. But I think there is something else going on. I do have some signs of Raynaud’s (often horrible circulation in my hands and feet). I would love any info on this. You mentioned you finally found out what was going on. What are some of the solutions. I’m so done battling with nipple pain!

      • Fleur (Nurtured Child) says:

        Hi Bri, I’m sorry to hear that you’re struggling with painful breastfeeding. Vasospasm can happen as a result of Reynaud’s, or can happen in response to trauma to the nipples. The symptoms are the same but the underlying cause is different. In either case, moms usually notice a colour change from pink to to white and then eventually back to pink. It happens due to decreased blood flow to the nipple and is usually very painful. Along with treating the underlying cause if the vasospasm is being caused by trauma, many mothers find applying heat to be helpful, and some moms find that vitamin B6 and magnesium supplements can help. In extreme cases, low doses of the blood pressure medication nifedipine have been found to be helpful. Has your baby been checked for tongue and/or lip-tie?

  22. Great post. I love that you mention complementary therapies for babies with structural difficulties, but I was disappointed to see that you didn’t mention Osteopathic Manipulative Medicine. If you can find a D.O. who offers it and has experience with babies, it can provide a lot of relief. Not to mention that because of the way our insurance system is set up in the US, it’s more likely to be covered by insurance than chiropractic care because it’s offered by a physician (I wish most insurance covered chiro or craniosacral, but it’s been my experience that they don’t.).

    • Fleur (Nurtured Child) says:

      An oversight on my part because in my own area, chiro and CST are far more common. There are certainly other types of complementary therapies that can be beneficial, and I’ve updated the post to reflect this. Thank you! 🙂

  23. I think it’s important that it becomes common knowledge that there are things like tongue tie, lip tie and structural issues. I had excrucuiating pain with my first for 8 weeks at every feed. It was horrible. I asked for help everywhere I could and all I heard was you’re doing so well the latch is great. Well, I wasn’t doing well. The only way to cope with it was to become cynical about the “there shouldn’t be any pain” statement. I stopped believing it. With my second I had no pain at all. I’ve since noticed a lip tie in my first… she was born by forceps. I wish I’d known this at the time and it could have saved me (and my daughter, who was a very unhappy camper, feeding constantly and screaming when not feeding) a lot of pain.

  24. This is a sensitive (so to speak, ha!) subject for me because I had an extremely difficult time nursing my son in the beginning. We stumbled onto a number of obstacles and somehow preserved. We are still nursing at 28 months. But my son had a terrible time latching. The IBCLC we saw in the hospital was invaluable. She gave exercises to use with him to teach him the right way to latch. This was not an overnight process, however and there were times I could not get him to latch at all and resorted to formula. Once I would get him latched, there was no way I was going to unlatch him if it was incorrect after spending 15 minutes or more trying to get a very frustrated and hungry baby to latch on. This obviously had an effect and caused pain for me and I had vasospasms too, but the pain I experienced was much more than that. I also had one flat and one inverted nipple. Latching him to the inverted nipple was excruciating at times. The pain went away around 5 weeks or so (vasospasms took longer but I could deal with those). Looking back, I think it was a combination of several factors but mostly, my body had to learn and make adjustments as he needed to learn how to nurse properly as well. What would have been far more helpful for me to hear is that for some women, it can be painful in the beginning but that will ease over time(and typically a few weeks really). Mentally I could be better prepared instead of continually reading about how I must be doing something wrong because it hurt. I understand we want to reach women with fixable issues so they don’t give up, but we need to be careful how that message is given, or else it may have the opposite effect. Hearing, hang on, it will get better, is so much better than thinking that pain is forever and I’m not getting it so I may as well give up. I think we should tell women, Most of the time if there is pain, there is a something that can be fixed so please see an IBCLC. And then noting that it is painful for some women in the beginning but gets better soon and an IBCLC can help you find ways to cope in the meantime. Personally I think that is a much more positive message for everyone and more accurate. And I wish you had covered anatomical issues in the mom too–like flat and inverted nipples!

  25. I had ALL of these issues with my twins. Eventually the combination helped and we are still nursing at almost 8 months. Now I’m dealing with milk blisters and have learned the hard way that I can NOT nurse laying down. Bummer.

  26. I enjoyed your post, Kerstin. I’m not sure I could go through it again as it took close to 6 weeks before we could latch with no pain but I know I’d try because we persevered and it’s a breeze now at 4 mo. It was frustrating for me to hear everything looked good and experience the curling toes and heat wave come over my body when he’d latch and I did dread hearing him wake up to eat and would just sob as I stuck him on. I have hope that any future children will have an easier time. He does have a super strong suck and I’ve never had to worry that he wasn’t getting enough.

    • If it offers you any hope, it seemed that it took my body less and less time to adjust hormonally after each baby. The first took 8 weeks, the second took 6 weeks, the third and fourth were both about 3 weeks. After that it was pretty much home free 🙂 But we’re all different!

  27. Tyra Spears says:

    I am so happy read this as it gives me.an explanation. Baby #6 born by c-section (My only c-section) 4 weeks ago. Had trouble latching on and lost 1. 5 pounds in 2 weeki s. We are doing well now and he has almost regained his birth weight. Many tears were shed and I had to really remain persistent. Doctor really wanted me to change to formula but I just kept going. Can’t wait to share this article with her.

  28. I was also a little disappointed. It wasn’t what I thought.

    I had extreme pain with one of my babies and everything was “just right.” After having my second, I found out why. My first baby had a tremendously strong suckle. She went at my nipples with incredible force. I thought it was normal. I thought all babies sucked that hard. She sucked so hard that the skin pigment came out of my nipples. They went from brown to light pink – lighter than ususal pink – in just a few days. I nursed and nursed and the pain disappeared at about six weeks.

    After having my second four years later, I was concerned he wasn’t getting any milk because he had this gentle little suckle. I fretted and worried because he didn’t nurse like my first had. But he was peeing huge quantities and obviously growing well, so I was wrong.

    In my case, my daughter had too strong a suckle. I suspect that some babies just really go at it and prefer an incredibly strong suction.

    • I forgot about that aspect! I literally had little hickey like marks on my nipples!

    • Fleur (Nurtured Child) says:

      That super strong suck is actually one of the signs that there is something going on structurally with the baby that could be helped by chiropractic care or craniosacral therapy. It seems to be that those babies who are not able to suck correctly tend to increase the amount of vacuum they use when sucking as a means to compensate (which usually causes pain for mom).

      • Considering the problem resolved without that care, after my hormones evened out (all FOUR times), I doubt that all four of my babies needed chiropractic care. They were fine. My nipples were sensitive from hormones. There is no one size fits all for these things, and turning everything into a “there’s something wrong with you or your baby” does a GREAT disservice to women, and undermines their confidence.

        • Fleur (Nurtured Child) says:

          Babies are often able to self-correct structural issues after a period of time, the bodywork simply speeds up the process so that mom isn’t in pain for as long.
          I certainly agree with you that that there is no one-size fits all answer to breastfeeding issues, and there are certainly other possibilities (such as hormonal issues) that could be causing pain. As I mentioned in my post, tongue and lip-tie and structural issues are simply the two most common reasons that I see in my practice. Unfortunately it’s not feasible in a blog post to go into all of the possible reasons for pain, but I always take an individualized approach with the mothers I work with. My goal with this post was simply to bring to light two possible reasons for pain that are often overlooked because most health care providers haven’t been taught about them.
          I think it’s wonderful that you were able to nurse all of your babies despite the initial pain. I’ve been there myself and I know it’s not easy! 🙂

          • I guess what I’m trying to put out there is that hormonal changes should be on every list like this–I think it plays in to a majority of nursing issues, since most women do have hormone changes post partum (think PMS breast soreness. Imagine nursing while you have those hormones times 100 going through your body–it will make those toes curl! ) And I think professionals don’t really consider it enough, because it’s not something to fix and it’s natural to look for things to fix.

            I want to have this as part of the conversation because I think too much focus is on what is WRONG and we’re not really (as a general population) empowering mothers. I want that to change! I want my voice to help that change, so that no other mommy has to assume from the get go that she must be messing it up 🙂 I feel like people like me are actually pretty common, but very much underrepresented in these lists! I feel compelled to speak up about it! But I’ll let it go now, and hope others will at least consider it after reading this…and still others will get checked when they’re experiencing pain, but also consider it may just be natural for their bodies.

            • Christelle says:

              Thank you so much for this comment. I have felt so discouraged when I hear over and over “breastfeeding SHOULD NOT HURT” well in my case and as I see many other cases it does hurt and there is nothing wrong with mom or baby.
              Thank you again, that has really given me a boost 🙂

            • It still. Should not. Hurt.

      • Interesting info about the strong suck signifying potential structural issues — I’ve never heard that before. I didn’t have any interventions, but my daughter was posterior, I had to push for a long time, and she had a significant cone head when she came out. The cone head went away quickly but she sucked HARD and nursing was painful for the first five weeks. Meeting with a lactation consultant to improve latch definitely helped, but I never knew there were other treatment options. Luckily we’ve had no further issues and she’s still nursing at almost two.

  29. In my case, I think a SINGLE bad feed when my daughter was tiny caused lingering pain for weeks. I didn’t take her off the breast to reposition her, so there was damage, and then it just couldn’t heal. Hoping it goes a little easier this next time.

  30. I was excited to see this, but then disappointed to read it. I’ve successfully nursed 4 babies into toddlerhood, and every single one of them hurt. I am always SO frustrated to hear the “it’s not supposed to hurt” BS. For most people, sure, it’s not. But let me tell you, the very FIRST sign I was pregnant for me was that my nipples became incredibly sensitive, cracked, and chapped. At 5 weeks pregnant. 35 weeks before a latch was anywhere near my issue. When the baby came along (each time) with a super suction baracuda mouth, you better BELIEVE the nipples that hurt when water touched them hurt when my babies fed!
    I was one of the oh-so-lucky chicks who had ultra sensitivity, and I’m 99.9% sure that HORMONES caused it. Our latches were deemed perfect. My babies were fat and healthy. And breastfeeding hurt for the first 3-8weeks. And that WAS normal for me. If I had listened to the “it’s not supposed to hurt” people I would have given up the first go round. I almost did, thinking there was something wrong with me because of that statement. But my mom and sister confirmed their own painful beginnings, and thanks to that I questioned all the (very wrong) know it alls who had said that. We need to get that phrase OUT of lactation vocab and start looking at people as individual cases instead of cookie cutter “shoulds” and “shouldn’ts”. rant over. lol

    • Coudn’t agree with you more! I was excited to see the title, disappointed to read the article. I have successfully breastfed 3 children, and with my first (twins), I had such excruciating pain in the beginning that I considered pumping exclusively. My mother continued to reassure me that the pain was normal (although everything I read and every “professional” that I talked to told me that I shouldn’t be having any!). My nipples were so sensitive that it hurt to shower and for quite some time, I had to shield my nipples from the cold winter air! The pain went away at around 6 weeks. With my 3rd child, I had nipple pain for the first week and a half, and I ignored the LC at the hospital who told me that it shouldn’t hurt. The nipple sensitivity lasted for a few weeks longer. All of my babies gained weight and were perfectly content little newborns. And all 3 were delivered via C-section.

      • Fleur (Nurtured Child) says:

        Hi Julia, The situation you describe with your children is exactly the kind of situation where I usually find that there are structural issues with the baby that have been caused by either the delivery process, or the baby’s position in utero. These structural issues are often very subtle, and they usually don’t have a negative impact on the baby’s ability to transfer milk and gain weight (although they can), but they are enough to cause mom pain until the baby’s body manages to self-correct the issues in time. These are the kinds of situations that tend to benefit greatly from gentle bodywork for baby.

    • LOL, I was in labor when you posted this and had my daughter shortly thereafter. My first daughter, a big healthy 9 pounder had a suction that would put a shop vac to shame, came out that way…I had painful nipples and I just cringed to nurse… but my bloody nipples eventually healed and became shoe leather and my baby grew faster than anyone else I knew… Now my new baby, 10 lbs, has come out sucking like a machine as well and I am having the same issues. I am one of the lucky momma’s that have super high hormone levels. I barf until 14 weeks… super sensitive nipples…. daughters shed my hormones after birth and there is usually a bit of blood present…. the whole enchiliada with me… now.. it is great to read your posts. The suction is fantastic, i can hear the milk pour down, the latch looks text book, body position as well… still the pain… but it is subsiding. Thank you for mentioning the that this issue can be due to a super sucker… barracuda… is the BEST description… I call her a vampire…. and high hormone levels. My nipples are so sensitive during pregnancy… my bra turns me on something fierce… if ya get my drift.
      Your post has encouraged me that there isn’t something wrong with me or my baby. I will do as before and put my big girl panties on and take one for the team! Comfrey tincture helps immensely, just be sure to wipe it off before nursing and also lanolin. Oh, my nipples are so cold, that i asked my hubby to go kill a rabbit for me for the fur,…. cold weather hurts as bad as the babys hoover mouth…. don’t get me started on shower water………………….OUCH! Good luck ladies

    • thank you so much for posting! you are speaking my mind. whether the hormones or just the physical stimulus is what changes the pain later, the fact is, it is very NORMAL to have pain in the early stages of breastfeeding.
      mother of 3 healthy fat babies, all breastfed for more than 2 years!

  31. I ended up seeing a lactation consultant 3 weeks pp. I was having toe curling pain. That is the perfect way to describe it. In fact, the day I went to the appointment I had exclusively pumped/bottle fed for the last 6 days because the pain was so unbearable. She said his latch was great and the pain was mostly gone too. The only thing I can figure is that his latch wasn’t good to begin with which started the pain and my nipples just couldn’t heal while I continued to try to breastfeed. For me, giving my nipples the week long break was a life saver. He turned 1 last week and is still a breastfeeding champ. I know that there can be an issue with nipple confusion so this might not be the best idea for everyone, but for us it worked.

  32. Great post Fleur. I cannot tell you (but I am sure you can guess!) how many times my clients have been told “oh but the latch is perfect” even when their nipples are cracked and bleeding and they are crying at the very thought of latching their baby!

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