Is this supposed to hurt?

One of the most common issues plaguing new moms is nipple pain. In fact, it is the second most common reason for weaning, after concerns about low milk supply (Witt 2012).

While initial discomfort can be common and even acceptable during the early postpartum period ( the pain is associated with initial latch and subsides after less than 30 seconds) Pain IS NOT something to push through. Your nipples do not need to "toughen up." You are not being a big, giant baby. 

There are many reasons for pain and one of the first strategies that will always be implemented is ensuring the latch technique is appropriate. Improper/shallow latch is one of the most common reasons for pain associated with breastfeeding. Some other common reasons include: :

-Low milk supply

-Oversupply/forceful milk ejection reflex

-Ankyloglossia (tongue tie)

-Plugged ducts/mastitis

-Engorgement

-Vasospasm

-Various skin conditions

-Trauma due to improper pump flange/suction pressure

-Anatomical variability of infant oral cavity

If poor latch positioning is the reason for your pain, the good news is making some simple postural/positioning adjustments can often make the difference between debilitating, toe curling pain and complete comfort during feeds. If you're lucky, you'll learn the latch basics prenatally. If you're not as lucky, your introduction to infant feeding may take the form of a well meaning nurse/doctor/aunt/mom emphatically smooshing your babies head into your breast and hoping for the best. While we often speak about "latching the baby," it is actually more appropriate to think of it as the "baby latching." Too often a well meaning and sometimes desperate mom finds herself chasing her babies mouth with her breast with the end result being a frustrated baby and/or a discouraged mom who is no further along the path.

 Allowing an infant to move through their own instinctive behaviours will allow them to self attach and begin their feed comfortably (for you and them). If some guidance is required, it should take the form of gentle support at the nape of babies neck (not the head) that facilitates the infants nose being aligned at your nipple before they open their mouths widely. This allows for them to be able to grasp a large mouthful of breast tissue. Ideally we should see the chin and cheeks pressed comfortably into the breast and babies nostrils should be visible.

Notice how the mother is holding her breast behind the areola so that her fingers don't cover where the babies mouth latches. It may take some practice, but it is important to unlatch and try to re latch the infant again if the pain persists or if you notice the latch appears shallow (baby is more so just holding onto the nipple and not enough breast tissue). If you are continuing to experience pain, despite having proper technique and trying various positions, you may need to seek the help of an experienced IBCLC who can help determine if one of any other number of factors may be contributing to your pain. In any event, it is most important to try to avoid and, if needed, properly manage nipple trauma to avoid risk of infection and further damage.